Individual
DAVA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 WALTERSCHEID BLVD, APT I 103, CHEYENNE, WY 82007-2333
(479) 313-2604
Mailing address
215 WALTERSCHEID BLVD, APT I 103, CHEYENNE, WY 82007-2333
(479) 313-2604
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/25/2015
Last updated
09/25/2015
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