Individual
KILEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 ANCHOR RD, DIXON, IL 61021-8829
(815) 288-6691
Mailing address
500 ANCHOR RD, DIXON, IL 61021-8829
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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