Individual
LACRESHA J JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 S JONES BLVD, LAS VEGAS, NV 89146-1231
(702) 979-9979
Mailing address
6498 ABBEY DOOR CT, LAS VEGAS, NV 89122-0848
(702) 249-1358
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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