Individual
MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
364 NEOLA ST, PARK FOREST, IL 60466-2334
(708) 362-8960
Mailing address
364 NEOLA ST, PARK FOREST, IL 60466-2334
(708) 362-8960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
172A00000X
Driver
Primary
—
—
172V00000X
Community Health Worker
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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