Individual
KELLY ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17505 N 79TH AVE STE 311GANDC, GLENDALE, AZ 85308-8725
(602) 876-2029
Mailing address
19865 W MONTEROSA ST, LITCHFIELD PARK, AZ 85340-5603
(623) 876-2029
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/08/2025
Last updated
11/08/2025
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