Individual
TERESA JOHNSON-IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2769 PLUMBERRY AVE, OCOEE, FL 34761-7727
(321) 217-4209
Mailing address
2769 PLUMBERRY AVE, OCOEE, FL 34761-7727
(321) 217-4209
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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