Individual
CHRISTY GAIL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
840 SW 4TH AVE STE 103, ONTARIO, OR 97914-2638
(541) 881-7330
Mailing address
1337 N HIGHWOOD AVE, BOISE, ID 83713-2213
(503) 750-6752
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15395
OR
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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