Individual
MS. KALIYAH SHANICE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NA
Contact information
Practice address
124 WATERFORD POINTE CIR UNIT 2206, MYRTLE BEACH, SC 29579-2708
(843) 360-0515
Mailing address
124 WATERFORD POINTE CIR UNIT 2206, MYRTLE BEACH, SC 29579-2708
(843) 360-0515
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10097321
SC
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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