Individual
BETH A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC SLP L
Contact information
Practice address
201 W SPRINGFIELD AVE STE 702, CHAMPAIGN, IL 61820-4845
(217) 215-3016
(217) 215-3016
Mailing address
201 W SPRINGFIELD AVE STE 702, CHAMPAIGN, IL 61820-4845
(217) 215-3016
(217) 215-3016
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007061
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK
IL
01
—
203
BLUE CROSS
IL
01
—
4117
HEALTH ALLIANCE
IL
01
—
7216
PERSONAL CARE
IL
Enumeration date
06/12/2008
Last updated
01/28/2023
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