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NPI Code Detail

MEDICARE: MS. SATONIA RENAE JOHNSON IMH

MEDICARE: MS. SATONIA RENAE JOHNSON IMH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation FacilityIMH 14002FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1IMH 14002OTHERFLREGISTERED MENTAL HEALTH COUNSELOR INTERN

General Provider Information

NPI Number : 1225409972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SATONIA RENAE JOHNSON IMH
Provider Business Mailing Address
First Line : 7413 SHERREN DR
Second Line :
City : TAMPA
State : FL
Zip : 33619-4737
Country : US
Telephone Number : 813-417-9162
Fax Number :
Provider Business Practice Location Address
First Line : 7413 SHERREN DR.
Second Line :
City : TAMPA
State : FL
Zip : 33619-4737
Country : US
Telephone Number : 813-417-9162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2015
Last Update Date : 10/07/2015

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