Most Relevant Information
Provider Data
| NPI Number: | 1003329590 |
| Provider Name: | MICHELLE LYNNE JOHNSON CERTIFIED HAIR LOSS |
| Entity Type: | Individual |
| Taxonomy Code: | 1744P3200X |
| Specialty: | Specialist |
| License Number: | 1097244 |
Most Important Dates
| Enumeration Date: | 11/07/2017 |
| Last Updated: | 11/07/2017 |
Provider Practice Location
1891 RIVER ST
HYDE PARK
MA
021361418
Practice Location Phone/Fax
| Phone: | 6173337434 |
| Fax: |
Provider Mailing Location
1891 RIVER ST
HYDE PARK
MA
021361418
Provider Mailing Phone/Fax
| Phone: | 6173337434 |
| Fax: |