Individual
BRENDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1788 BROAD ST, CRANSTON, RI 02905-3520
(401) 499-5288
Mailing address
171 ARNOLD AVE, CRANSTON, RI 02905-3815
(401) 499-5288
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT01958
RI
Other
Enumeration date
07/15/2013
Last updated
07/15/2013
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