Individual
MYTAYA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 E CAPITOL ST SE, WASHINGTON, DC 20019-4460
(240) 483-7288
Mailing address
15908 ATLANTIS DR, BOWIE, MD 20716-3849
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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