Individual
MRS. SHAYNE ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
2 ROSELL DR, BALLSTON LAKE, NY 12019-1433
(518) 663-6000
Mailing address
2 ROSELL DR, BALLSTON LAKE, NY 12019-1433
(518) 663-6000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
029455
NY
235Z00000X
Speech-Language Pathologist
011212-1
NY
Other
Enumeration date
01/22/2010
Last updated
01/02/2026
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