Individual
MS. SOPHIA JOHNSON-HARGRAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13060 176TH PL, JAMAICA, NY 11434-5850
(347) 520-6797
Mailing address
13060 176TH PL, JAMAICA, NY 11434-5850
(347) 520-6797
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
302905-1
NY
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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