Individual
MISS SONSERAY D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PBT
Contact information
Practice address
7950 CROSSROADS DR APT 113, NORTH CHARLESTON, SC 29406-9414
(888) 910-0573
Mailing address
2139 TARGET ST, NORTH CHARLESTON, SC 29406-6263
(843) 374-9084
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-1932845
—
SC
Enumeration date
05/07/2022
Last updated
05/07/2022
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