Individual
KELLY ANITA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD-SLP
Contact information
Practice address
74 CAMPUS DR, MAYNARD, AR 72444-9225
(870) 647-3524
(870) 647-2301
Mailing address
147 ELLIS RD, POCAHONTAS, AR 72455-8906
(870) 647-3524
(870) 647-2301
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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