Individual
DOMINIQUE SHAKIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21229 HILLSIDE AVE APT 7MW, QUEENS VILLAGE, NY 11427-1823
(347) 869-8952
Mailing address
21229 HILLSIDE AVE APT 7MW, QUEENS VILLAGE, NY 11427-1823
(347) 869-8952
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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