Individual
MRS. MELINDA CATHERINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2736 W 10TH ST, LAKELAND, FL 33805-3982
(863) 255-9370
(863) 255-9370
Mailing address
1106 MELVILLE AVE, LAKELAND, FL 33805-3959
(863) 255-9370
(863) 255-9370
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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