Individual
HEIDI JOHANNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
10535 HOSPITAL WAY, 126-S, MATHER, CA 95655-4200
(916) 843-7552
Mailing address
1108 G ST, # 1/2, SACRAMENTO, CA 95814-0825
(310) 872-4625
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
21531
CA
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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