Most Relevant Information
Provider Data
| NPI Number: | 1003441494 |
| Provider Name: | CONSTANCE JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/06/2020 |
| Last Updated: | 03/06/2020 |
Provider Practice Location
769 E MASTEN CIR
MILFORD
DE
199631091
Practice Location Phone/Fax
| Phone: | 3022259267 |
| Fax: |
Provider Mailing Location
769 E MASTEN CIR
MILFORD
DE
199631091
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |