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Individual

MRS. DONNA MARIE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5116 W LA MIRADA DR, LAVEEN, AZ 85339-9601
(602) 237-4525
Mailing address
5116 W LA MIRADA DR, LAVEEN, AZ 85339-9601
(602) 237-4525

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9366
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
983488
ARIZONA HEALTH CARE COST
AZ
Enumeration date
01/29/2007
Last updated
07/08/2007
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