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KIMBERLY JOHNSON

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1215397104

Individual Registrant:
 KIMBERLY  JOHNSON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1312 W COLLIN RAYE DR  DE QUEEN, AR 71832-2135 US
Tel: 870-584-7115  Fax: 870-642-3388

Contact information for business:
2904 ARKANSAS BLVD  TEXARKANA, AR 71854-2536 US
Tel: 870-773-4655  Fax: 870-772-4650

Registration Information:
NPI: 1215397104
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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