Individual
MARY JANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED.
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
051097
RI
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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