Individual
MS. GERALYN L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4133 192ND CT, COUNTRY CLUB HILLS, IL 60478-5807
(708) 705-7399
Mailing address
4133 192ND CT, COUNTRY CLUB HILLS, IL 60478-5807
(708) 705-7399
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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