Individual
DEBORAH ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 FOOTE AVE, JAMESTOWN, NY 14701-7077
(716) 664-8270
Mailing address
207 FOOTE AVE, JAMESTOWN, NY 14701-7077
(716) 664-8270
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
1104795
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104795
NUTRITION AND DIETETICS TECHNICIAN, REGISTERED
NY
Enumeration date
03/28/2018
Last updated
03/28/2018
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