Individual
MIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
5750 E UNIVERSITY BLVD APT 711, DALLAS, TX 75206-4284
(214) 330-0036
Mailing address
5750 E UNIVERSITY BLVD APT 711, DALLAS, TX 75206-4284
(214) 330-0036
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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