Individual
DELORES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
671 HOES LN W, PISCATAWAY, NJ 08854-8021
(973) 972-8277
Mailing address
671 HOES LN W, PISCATAWAY, NJ 08854-8021
(973) 972-8277
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4144007
—
NJ
Enumeration date
07/21/2014
Last updated
07/21/2014
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