Provider Demographics
NPI:1386493534
Name:JOHNSON, SHENEEFAH (HP)
Entity type:Individual
Prefix:
First Name:SHENEEFAH
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:HP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1982 ROGERS AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5070
Mailing Address - Country:US
Mailing Address - Phone:234-571-8844
Mailing Address - Fax:
Practice Address - Street 1:1982 ROGERS AVE SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5070
Practice Address - Country:US
Practice Address - Phone:234-571-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach