Individual
DEMETRIUS DE'SHON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 SANDS AVE, 2515 S BRUCE ST, LAS VEAS, NV 89169
(602) 704-6917
Mailing address
2515 S BRUCE ST, LAS VEGAS, NV 89169-1773
(602) 704-6917
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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