Individual
MRS. LINDA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1703 60TH ST, KENOSHA, WI 53140
(262) 658-4125
(262) 658-2196
Mailing address
1000 BEVERLY WAY, AEGIS THERAPIES, FORT SMITH, AR 72919
(877) 823-8375
(479) 201-2703
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
602154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42725300
—
WI
Enumeration date
09/09/2008
Last updated
09/09/2008
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