Individual
KELLY THERESA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5272 RIVER RD STE 100, BETHESDA, MD 20816-1454
(703) 429-1853
Mailing address
3409 WISCONSIN AVE NW APT 2, WASHINGTON, DC 20016-3008
(203) 233-1678
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000112
VA
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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