Provider Demographics
NPI:1437479912
Name:ARMENTROUT, JOHNNE WHICKER (MAED)
Entity Type:Individual
Prefix:MS
First Name:JOHNNE
Middle Name:WHICKER
Last Name:ARMENTROUT
Suffix:
Gender:F
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 RYAN WAY
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3545
Mailing Address - Country:US
Mailing Address - Phone:336-758-5273
Mailing Address - Fax:336-758-1991
Practice Address - Street 1:3822 RYAN WAY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3545
Practice Address - Country:US
Practice Address - Phone:336-758-5273
Practice Address - Fax:336-758-1991
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional