Individual
MS. LAURAL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7201 S PAXTON AVE, CHICAGO, IL 60649-2519
(773) 718-5862
Mailing address
7201 S PAXTON AVE, CHICAGO, IL 60649-2519
(773) 718-5862
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/06/2009
Last updated
07/06/2009
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