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Individual

DEANDRA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
307 BELLFLOWER AVE NW, CANTON, OH 44708-5607
(234) 804-9552
Mailing address
307 BELLFLOWER AVE NW, CANTON, OH 44708-5607
(234) 804-9552

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0230613
OH
Enumeration date
12/31/2021
Last updated
12/31/2021
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