Individual
MARQUISHA LAVONE JOHNSON-WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7604 BERMEJO RD, FORT WORTH, TX 76112-6108
(817) 683-3936
Mailing address
7604 BERMEJO RD, FORT WORTH, TX 76112-6108
(817) 683-3936
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
714040
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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