Individual
MS. TYLER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CCMA, CNA
Contact information
Practice address
15000 CICERO AVE STE 100, OAK FOREST, IL 60452-1480
(219) 315-0565
Mailing address
5613 HYLES BLVD, HAMMOND, IN 46320-1971
(219) 315-3333
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227022331
IL
376K00000X
Nurse's Aide
CNA1003930
IN
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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