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General NPI Number Information
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NPI Number | 1932996618
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Entity Type | Individual
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Provider Name | SHANNON JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 13627 COUNTY ROAD 4195D
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City | HENDERSON
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State | TX
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Zip | 75654-8247
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Country | US
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Telephone | 903-722-0325
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 GLENDON CT
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City | DUBLIN
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State | OH
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Zip | 43016-3246
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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