Individual
ALICIA VIRGINIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRS
Contact information
Practice address
12201 EUCLID AVE, CLEVELAND, OH 44106-4310
(216) 721-4010
Mailing address
5227 W 148TH ST, BROOKPARK, OH 44142-1720
(216) 926-1716
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.000895
OH
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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