Individual
DENISE OLIVER JOHNSON-MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3128 ILLINOIS AVE, NORFOLK, VA 23513-4128
(757) 228-0724
Mailing address
3128 ILLINOIS AVE, NORFOLK, VA 23513-4128
(757) 228-0724
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
6650
VA
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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