Individual
JACQUELINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
773 GILBERT ST, COLUMBUS, OH 43206-1516
(614) 266-8033
Mailing address
773 GILBERT ST, COLUMBUS, OH 43206-1516
(614) 266-8033
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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