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MS. BRENDA LEE JOHNSON 09/28/1965

>> Foster Care Agency >> Agencies

Registrant NPI Number: 1942633276

Individual Registrant:
MS. BRENDA LEE JOHNSON 09/28/1965
Gender: F
Sole Proprietor

Location and contact information for practice:
308 SW. SHELBY AVENUE  MADISON, FL 32340-2334 US
Tel: 850-973-0591  Fax: --

Contact information for business:
308 SW. SHELBY AVENUE  MADISON, FL 32340-2334 US
Tel: 850-973-0591  Fax: --

Registration Information:
NPI: 1942633276
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y253J00000XAgencies
Foster Care Agency
FL008047400

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS FL - Page 1



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