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1477066520
JACQUALINE TIA JOHNSON
LODI, CA
NPI
1477066520
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-11-13
Last Update Date
2017-11-13
Business Address
JACQUALINE TIA JOHNSON
1209 W TOKAY ST STE 5
LODI, CA 95240-3845
Phone number: 209-331-2070
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Mailing Address
JACQUALINE TIA JOHNSON
1209 W TOKAY ST STE 5
LODI, CA 95240-3845
Phone number:
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