Individual
ANTONARIA DEANDRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
1080 KAREN CT APT 2, PAHRUMP, NV 89048-5868
(775) 419-8894
Mailing address
1080 KAREN CT APT 2, PAHRUMP, NV 89048-5868
(775) 419-8894
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
NV20201981411
NV
171M00000X
Case Manager/Care Coordinator
Primary
NV20201981411
NV
Other
Enumeration date
01/01/2021
Last updated
11/07/2023
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