Most Relevant Information
Provider Data
| NPI Number: | 1003663923 |
| Provider Name: | SAMUEL JAMES JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/30/2024 |
| Last Updated: | 04/30/2024 |
Provider Practice Location
2524 HIDDEN SHORES DR APT 103
VIRGINIA BEACH
VA
234543239
Practice Location Phone/Fax
| Phone: | 7572351811 |
| Fax: |
Provider Mailing Location
2524 HIDDEN SHORES DR APT 103
VIRGINIA BEACH
VA
234543239
Provider Mailing Phone/Fax
| Phone: | 7572351811 |
| Fax: |