Individual
SHANNAH L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
2675 GRAND CONCOURSE, #4F, BRONX, NY 10468-3745
(612) 360-1491
Mailing address
2675 GRAND CONCOURSE, #4F, BRONX, NY 10468-3745
(612) 360-1491
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
885503
NY
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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