Individual
MRS. LISA DAWN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
N3811 BIG FIELD RD, BLACK RIVER FALLS, WI 54615-5209
(715) 284-9291
Mailing address
N3811 BIG FIELD ROAD, BLACK RIVER FALLS, WI 54615
(715) 284-9291
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
J525000166612
WI
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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