Johnson, Jacqueline
Johnson, Jacqueline is an sole proprietor health care provider with primary practice located at 2107 Gardenwood Ct , Atlanta GA 30349. She recently has only one registered license in Behavioral Health & Social Service Providers / Health Service, which is considered as her primary health care specialty. Johnson, Jacqueline can be contacted via phone (404) 857-8639.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X |
Profile Details
| NPI number | 1811160740 |
|---|---|
| LBN Legal business name | Johnson, Jacqueline |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 11th, 2008 |
| Last updated | Aug 1st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811160740 | NPPES |
| Georgia | MEDICAID | 372320984B |
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