| NPI | 1104662246 |
|---|---|
| Former Name | JENNIFER JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 172A00000X Driver |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |