Individual
FREDRICKLYN EDWINA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13113 CAMERON GROVE LOOP APT 307, CHARLOTTE, NC 28262-2825
(617) 309-6716
Mailing address
13113 CAMERON GROVE LOOP APT 307, CHARLOTTE, NC 28262-2825
(617) 309-6716
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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