Individual
MS. TRACYE MARIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
66 DELHAM AVE, BUFFALO, NY 14216-3309
(716) 319-4124
Mailing address
66 DELHAM AVE, BUFFALO, NY 14216-3309
(716) 319-4124
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
NY
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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