Individual
TYONNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6501 W FOND DU LAC AVE, MILWAUKEE, WI 53218-5835
(414) 748-5992
Mailing address
PO BOX 18281, MILWAUKEE, WI 53218-0281
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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