Individual
SHANAYA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2519 GERMANTOWN AVE, PHILADELPHIA, PA 19133-1636
(610) 712-0795
Mailing address
2519 GERMANTOWN AVE, PHILADELPHIA, PA 19133-1636
(610) 712-0795
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
70683601
PA
376J00000X
Homemaker
70683601
PA
385H00000X
Respite Care
70683601
PA
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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