MR. Jaquez Terell Johnson, MBA
NPI #1457192148 in Lake Wales, Florida
Provider Information
- NPI Number
- 1457192148
- Entity Type
- Individual
- Name
- MR. Jaquez Terell Johnson, MBA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Case Manager/Care Coordinator
- Credential
- MBA
- Enumeration Date
- Jun 5, 2024
- Last Updated
- Jun 5, 2024
Practice Location
- Address
- 113 DINNER LAKE AVE
- City
- Lake Wales
- State
- Florida
- ZIP Code
- 33859-2155
- Phone
- (662) 769-4077
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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