Individual
RASHANDIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
2707 WALKER DR, FORT PIERCE, FL 34946-1170
(772) 332-1902
Mailing address
2707 WALKER DR, FORT PIERCE, FL 34946-1170
(772) 332-1902
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
06162008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06162008
—
FL
Enumeration date
02/01/2013
Last updated
02/01/2013
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