Individual
MRS. ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 BRIARBROOK DR, EAST PEORIA, IL 61611-4474
(309) 338-9204
Mailing address
103 BRIARBROOK DR, EAST PEORIA, IL 61611-4474
(309) 338-9204
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1460007925
IL
Other
Enumeration date
09/07/2017
Last updated
07/21/2022
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