Individual
CLARISSA MARIE JOHNNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9185 MONICA ST, BEAUMONT, TX 77707-4635
(409) 433-7433
Mailing address
3910 TREADWAY RD APT 803, BEAUMONT, TX 77706-7137
(409) 433-7433
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
340841
TX
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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