Individual
TIA DE'ANTRANISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7868 FOREST LOOP, PINSON, AL 35126-4087
(205) 356-6337
Mailing address
7868 FOREST LOOP, PINSON, AL 35126-4087
(205) 356-6337
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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