| NPI | 1104236850 |
|---|---|
| Other Name | SHAKEVIA VONTA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MA 286906) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TN 55603) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 24841) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: MA 286906) | |
| Enumeration Date | 2014-05-03 |
| Last Update Date | 2022-02-15 |