Provider Demographics
NPI:1700011319
Name:JOHNSON, DANARIA MARIE (MS)
Entity Type:Individual
Prefix:MISS
First Name:DANARIA
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 WOLFSKIN RD
Mailing Address - Street 2:
Mailing Address - City:ARNOLDSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30619-2218
Mailing Address - Country:US
Mailing Address - Phone:706-248-5080
Mailing Address - Fax:
Practice Address - Street 1:736 WOLFSKIN RD
Practice Address - Street 2:
Practice Address - City:ARNOLDSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30619-2218
Practice Address - Country:US
Practice Address - Phone:706-248-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
GALPC008227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor