Most Relevant Information
Provider Data
| NPI Number: | 1003271891 |
| Provider Name: | SHELLEY JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YS0200X |
| Specialty: | Counselor |
| License Number: | 293288 |
Most Important Dates
| Enumeration Date: | 12/21/2015 |
| Last Updated: | 12/21/2015 |
Provider Practice Location
3840 5TH AVE N
ST PETERSBURG
FL
337137521
Practice Location Phone/Fax
| Phone: | 7273672273 |
| Fax: |
Provider Mailing Location
3840 5TH AVE N
ST PETERSBURG
FL
337137521
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |