Individual
MRS. HEATHER LYNNE JOHANSON-WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
203 MADISON AVE, VALHALLA, NY 10595-1827
(914) 522-7651
Mailing address
203 MADISON AVE, VALHALLA, NY 10595-1827
(914) 522-7651
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
010605
NY
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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