Individual
MRS. JUDITH ANN JOHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TSHH,TOD,SPEC. ED.
Contact information
Practice address
34 FROST MILL RD, MILL NECK, NY 11765-1102
(516) 922-4100
(516) 922-4172
Mailing address
12 WALKER AVE, SYOSSET, NY 11791-4027
(516) 921-2848
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
028536-1
NY
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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