Individual
JEAN MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
831 GRACE DR W, TWIN FALLS, ID 83301-3296
(215) 410-6377
Mailing address
831 GRACE DR W, TWIN FALLS, ID 83301-3296
(215) 410-6377
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2278
ID
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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