Provider Demographics
NPI:1558643197
Name:JOHNSON, TURKESSA SHERMAINE (CTRS)
Entity Type:Individual
Prefix:MS
First Name:TURKESSA
Middle Name:SHERMAINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 WINGSAIL CT
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3323
Mailing Address - Country:US
Mailing Address - Phone:443-624-2101
Mailing Address - Fax:
Practice Address - Street 1:AVE D
Practice Address - Street 2:PMRS 117
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL42399225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist