Individual
NICOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8802 ROCKAWAY BEACH BLVD, ROCKAWAY BEACH, NY 11693-1609
(718) 570-4364
Mailing address
8802 ROCKAWAY BEACH BLVD, ROCKAWAY BEACH, NY 11693-1609
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
024508
NY
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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