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Individual

JENNY L JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
152 E MAIN ST, SUITE 110, RIGBY, ID 83442-5266
(208) 745-7101
(208) 745-0068
Mailing address
152 E MAIN ST, STE. 110, RIGBY, ID 83442-5266
(208) 745-7101
(208) 745-0068

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1810
ID

Other

Enumeration date
01/16/2009
Last updated
01/16/2009
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