Individual
JHALYSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FPA-P
Contact information
Practice address
274 N GOODMAN ST STE D103, ROCHESTER, NY 14607-1173
(585) 514-0653
Mailing address
274 N GOODMAN ST STE D103, ROCHESTER, NY 14607-1173
(585) 514-0653
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0948
NY
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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