Individual
TRIVY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
C81080
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000000
N/A
—
Enumeration date
01/21/2019
Last updated
05/26/2022
Update your record
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