Individual
TAMIKA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
158 MATTOX RD, TUPELO, MS 38801-9140
(662) 308-8326
Mailing address
PO BOX 1352, VERONA, MS 38879-1352
(662) 308-8326
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
MS
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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