IndividualActive
Antoinette Johnson
NPI 1962107326 · Specialist · Saint Louis, MO
Provider details
- NPI number
- 1962107326
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
3863 Cleveland Ave
Saint Louis, MO 63110-4009
Phone: (314) 664-3927
Fax: (314) 664-0556
Approximate (ZIP-level) locationGet directions
Mailing address
3863 Cleveland Ave
Saint Louis, MO 63110-4009
Registry dates
- Enumerated
- 2023-04-04
- Last updated
- 2023-04-04
- Certified
- 2023-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.