Most Relevant Information
Provider Data
| NPI Number: | 1003597428 |
| Provider Name: | TINA MARIE JOHNSON MSSW, MA, MPA |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/27/2023 |
| Last Updated: | 07/27/2023 |
Provider Practice Location
204 E MARKET ST
LOUISVILLE
KY
402021218
Practice Location Phone/Fax
| Phone: | 5025884340 |
| Fax: |
Provider Mailing Location
4204 BOONES GROVE WAY
LOUISVILLE
KY
402997406
Provider Mailing Phone/Fax
| Phone: | 5023144844 |
| Fax: |