Individual
ANTWONISHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5520 W IDLEWILD AVE, TAMPA, FL 33634-8015
(813) 901-3418
Mailing address
5520 W IDLEWILD AVE, TAMPA, FL 33634-8015
(813) 901-3418
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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