Individual
MS. BONNIE R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
1006 FIELDCREST DR, ROCKFORD, IL 61108-4162
(815) 397-3345
(815) 229-9846
Mailing address
1006 FIELDCREST DR, ROCKFORD, IL 61108-4162
(815) 397-3345
(815) 229-9846
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
BJ36560400P
KY
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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