Individual
BARBARA JEAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6248 HOLLY BAY DR, JACKSONVILLE, FL 32211-3932
(904) 535-4113
Mailing address
6248 HOLLY BAY DR, JACKSONVILLE, FL 32211-3932
(904) 535-4113
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-2962765
—
FL
Enumeration date
09/07/2022
Last updated
09/07/2022
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