Individual
MS. MALLISSIE V JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12935 MAIN ST, HOUSTON, TX 77035-5603
(281) 682-6498
Mailing address
5563 LIVE OAK ST, #6, HOUSTON, TX 77004-7556
(281) 682-6498
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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