Individual
DEBRA SUSAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
912 HEMLOCK RD, GULFPORT, MS 39503-5848
(228) 831-1382
Mailing address
912 HEMLOCK RD, GULFPORT, MS 39503-5848
(228) 831-1382
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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