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1568979235
STAR JOHNSON
DAYTONA BEACH, FL
NPI
1568979235
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Additional Taxonomies
252Y00000X Early Intervention Provider Agency
Enumeration Date
2018-01-04
Last Update Date
2018-01-04
Business Address
STAR JOHNSON
201 THORNBERRY BRANCH LN
DAYTONA BEACH, FL 32124-3652
Phone number: 386-872-4892
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Mailing Address
STAR JOHNSON
201 THORNBERRY BRANCH LN
DAYTONA BEACH, FL 32124-3652
Phone number: 386-872-4892
Copy
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