Individual
MRS. HEATHER MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
1304 W BRADLEY AVE, CHAMPAIGN, IL 61821-2035
(217) 356-9176
(217) 356-9851
Mailing address
1304 W. BRADLEY AVE., CHAMPAIGN, IL 61821
(217) 356-9176
(217) 356-9851
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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