Individual
PATRICIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 TRUXTON LN, FORT SALONGA, NY 11768-2543
(631) 742-7574
Mailing address
8 TRUXTON LN, FORT SALONGA, NY 11768-2543
(631) 742-7574
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/18/2008
Last updated
08/29/2014
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