Individual
HEIDI WYNELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3020 S 6TH ST, SPRINGFIELD, IL 62703-5915
(217) 528-7541
(217) 789-2569
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007077
IL
Other
Enumeration date
09/26/2008
Last updated
05/22/2020
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