Individual
OCTAVIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7207 BELTZ DR, DISTRICT HEIGHTS, MD 20747-4601
(202) 210-4931
Mailing address
7207 BELTZ DR, DISTRICT HEIGHTS, MD 20747-4601
(202) 210-4931
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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