Individual
LISA ADELL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14300 GALLANT FOX LN, BOWIE, MD 20715-4003
(301) 325-3594
Mailing address
PO BOX 51, SEVERN, MD 21144-0051
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M06403
MD
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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