Individual
ELLEN JOHANSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4780 DATA CT, ORLANDO, FL 32817-8331
(407) 852-3300
Mailing address
111 COUNTRY HILL DR, LONGWOOD, FL 32779-2402
(407) 620-7171
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA21824
FL
Other
Enumeration date
09/19/2022
Last updated
10/25/2024
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