Individual
MARY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SP
Contact information
Practice address
1290 E OCOTILLO RD, GILBERT, AZ 85298-9222
(218) 205-1814
Mailing address
1525 W FRYE RD, CHANDLER, AZ 85224-6112
(480) 812-7095
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6486859
AZ
Other
Enumeration date
11/20/2021
Last updated
11/20/2021
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