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Individual
MARY ELIZABETH JOHNSON
Active
Individual
MARY ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.003704
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146.003704
IDFPR
IL
01
—
363559
ISBE
IL
Enumeration date
12/03/2018
Last updated
12/03/2018
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