Most Relevant Information
Provider Data
| NPI Number: | 1003634171 |
| Provider Name: | HOSTONIA SEGREE JOHNSON LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | SW22483 |
Most Important Dates
| Enumeration Date: | 09/28/2024 |
| Last Updated: | 10/16/2024 |
Provider Practice Location
101 RIVERFRONT BLVD STE 100
BRADENTON
FL
342058870
Practice Location Phone/Fax
| Phone: | 8669365250 |
| Fax: |
Provider Mailing Location
3222 KLAYS CT
ROYAL PALM BEACH
FL
334118324
Provider Mailing Phone/Fax
| Phone: | 8632283370 |
| Fax: |