Individual
JACQUELINE JACINDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
1867 NOCTURNE AVE NE, WARREN, OH 44483-4741
(133) 088-1679
Mailing address
1867 NOCTURNE AVE NE, WARREN, OH 44483-4741
(330) 881-6793
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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