Individual
MADISON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4214 SHERIDAN RD, MOUNT PLEASANT, WI 53403-4142
(262) 554-5006
Mailing address
4214 SHERIDAN RD, MOUNT PLEASANT, WI 53403-4142
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5203154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14380102
ASHA NUMBER
WI
01
—
5203154
WI DSPS
WI
Enumeration date
07/13/2022
Last updated
08/30/2022
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