Individual
AMANDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 EAGLE CTR STE 5, O FALLON, IL 62269-1947
(618) 334-4550
Mailing address
8 EAGLE CTR STE 5, O FALLON, IL 62269-1947
(618) 334-4550
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/14/2010
Last updated
02/16/2015
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