MS. Brenda Lee Johnson, 09/28/1965

NPI #1942633276 in Madison, Florida

Provider Information

NPI Number: 1942633276
Entity Type: Individual
Name: MS. Brenda Lee Johnson, 09/28/1965
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Foster Care Agency
Credential: 09/28/1965
Enumeration Date: Aug 9, 2013
Last Updated: Oct 8, 2014

Practice Location

Address: 308 SW. SHELBY AVENUE
City: Madison
State: Florida
ZIP Code: 32340-2334
Phone: (850) 973-0591

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Foster Care Agency	253J00000X	Primary

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