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1841767878
FANTASIA NICOLE JOHNSON
CITRUS HEIGHTS, CA
NPI
1841767878
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-10-29
Last Update Date
2018-10-29
Business Address
Miss FANTASIA NICOLE JOHNSON
6400 TUPELO DR # A
CITRUS HEIGHTS, CA 95621-1741
Phone number: 916-912-6808
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Mailing Address
Miss FANTASIA NICOLE JOHNSON
4845 MARY KATE DR # A
SACRAMENTO, CA 95841-2532
Phone number: 916-912-6808
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