Individual
REGINA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
907 S FLOAT AVE, FREEPORT, IL 61032-5830
(815) 701-2934
Mailing address
907 S FLOAT AVE, FREEPORT, IL 61032-5830
(815) 701-2934
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
IL
Other
Enumeration date
06/18/2022
Last updated
06/18/2022
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