Individual
JESSICA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 BROOKDALE ACRES DR, LYMAN, SC 29365-9793
(980) 255-0200
Mailing address
140 BROOKDALE ACRES DR, LYMAN, SC 29365-9793
(980) 255-0200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8273
SC
Other
Enumeration date
10/20/2023
Last updated
10/26/2023
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