Individual
MAIYA BRIELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5329 E 24TH AVE, ANCHORAGE, AK 99508-3807
(907) 223-6196
Mailing address
PO BOX 210541, ANCHORAGE, AK 99521-0541
(907) 223-6196
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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