Provider Demographics
NPI:1780369926
Name:JOHANSON-MURRAY, REMY (MS, NCC)
Entity type:Individual
Prefix:
First Name:REMY
Middle Name:
Last Name:JOHANSON-MURRAY
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:RU
Other - Middle Name:
Other - Last Name:JOHANSON-MURRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, NCC
Mailing Address - Street 1:1730 LOVELY LN
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-7026
Mailing Address - Country:US
Mailing Address - Phone:404-788-7435
Mailing Address - Fax:
Practice Address - Street 1:3720 CHAMBLEE DUNWOODY RD STE D2
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2064
Practice Address - Country:US
Practice Address - Phone:404-532-9497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty