Individual
SHEVONTE M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 CASALS APT 19A, BRONX, NY 06880
(203) 221-2812
Mailing address
100 CASALS APT 19A, BRONX, NY 06880
(203) 221-2812
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
CT
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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