Individual
DOMINIQUE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20165 PARKLANE DR, ROCKY RIVER, OH 44116-4046
(440) 476-3855
Mailing address
4320 ROCKY RIVER DR APT 104, CLEVELAND, OH 44135-1978
(330) 233-6940
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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