Individual
MARY A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1650 SE HOLIDAY CREST CIR, WAUKEE, IA 50263-8661
(615) 896-6400
Mailing address
5811 WOODLAND RD, DES MOINES, IA 50312-1253
(615) 896-6400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
001908
IA
Other
Enumeration date
04/13/2009
Last updated
04/13/2009
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