Provider Demographics
NPI:1285829788
Name:JOHNSON-HILL, SANDRA JEAN (LMT, NMT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JEAN
Last Name:JOHNSON-HILL
Suffix:
Gender:F
Credentials:LMT, NMT
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:JEAN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT, NMT
Mailing Address - Street 1:286 MOUNT VERNON DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-4017
Mailing Address - Country:US
Mailing Address - Phone:941-441-6395
Mailing Address - Fax:941-497-2269
Practice Address - Street 1:286 MOUNT VERNON DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-4017
Practice Address - Country:US
Practice Address - Phone:941-441-6395
Practice Address - Fax:941-497-2269
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-08
Last Update Date:2007-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA44138174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist