Individual
KATELYN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4065 SALADIN DR SE, GRAND RAPIDS, MI 49546-6249
(616) 942-2081
Mailing address
2370 GATETREE LN SE, GRAND RAPIDS, MI 49546-7590
(616) 826-1245
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101003103
MI
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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