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1114640190
SISSIE DIANE JOHNSON
FAIRMONT, WV
NPI
1114640190
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
(Licence: WV E949982)
Enumeration Date
2022-09-23
Last Update Date
2022-09-23
Business Address
SISSIE DIANE JOHNSON
16 MOUNTAIN PARK DR
FAIRMONT, WV 26554-8992
Phone number: 304-816-3687
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Mailing Address
SISSIE DIANE JOHNSON
16 MOUNTAIN PARK DR
FAIRMONT, WV 26554-8992
Phone number: 304-816-3687
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