Individual
MISS THERA ELESISUS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
2031 NW 184TH ST, MIAMI GARDENS, FL 33056-2753
(305) 502-8923
(305) 624-6804
Mailing address
2031 NW 184TH ST, MIAMI GARDENS, FL 33056-2753
(305) 502-8923
(305) 624-6804
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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