Individual
BIANCA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3090 N 53RD ST, MILWAUKEE, WI 53210-1617
(414) 254-4267
Mailing address
5822 N 76TH ST, MILWAUKEE, WI 53218-1836
(414) 803-3224
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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