Individual
MARY CAROLINE JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1101 VETERANS DR, 126-CDD, LEXINGTON, KY 40502-2235
(859) 281-4972
Mailing address
3356 GRASMERE DR, LEXINGTON, KY 40503-4020
(859) 223-4805
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0941
KY
Other
Enumeration date
04/13/2006
Last updated
07/08/2007
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