Individual
MS. JOHNETTA LARESA STUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1674 HAWTHORNE PL, WELLINGTON, FL 33414-8663
(561) 567-2969
Mailing address
1674 HAWTHORNE PL, WELLINGTON, FL 33414-8663
(561) 567-2969
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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