Provider Demographics
NPI:1770244519
Name:JOHNSON-ARNOLD, LETITIA P (MS, CHES, NBC-HWC)
Entity Type:Individual
Prefix:DR
First Name:LETITIA
Middle Name:P
Last Name:JOHNSON-ARNOLD
Suffix:
Gender:F
Credentials:MS, CHES, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 ELLIE AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-8579
Mailing Address - Country:US
Mailing Address - Phone:984-444-9533
Mailing Address - Fax:
Practice Address - Street 1:1722 ELLIE AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-8579
Practice Address - Country:US
Practice Address - Phone:984-444-9533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8216174H00000X
CAA-3399877
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No174H00000XOther Service ProvidersHealth Educator