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Individual

TYMECKIA LAVANA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
148 W ORION ST STE C-3, TEMPE, AZ 85283-5603
(480) 597-8121
Mailing address
339 N 75TH ST APT 328, MESA, AZ 85207-7452
(480) 587-3237

Taxonomy

Speciality
Code
Description
License number
State
225CX0006X
Orientation and Mobility Training Rehabilitation Counselor
Primary

Other

Enumeration date
11/17/2022
Last updated
11/17/2022
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