Individual
MARY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HOME HEALTH AIDE
Contact information
Practice address
355 5TH ST, ELYRIA, OH 44035-5705
(440) 990-5938
Mailing address
355 5TH ST, ELYRIA, OH 44035-5705
(440) 990-5938
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
308354
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308354
—
OH
Enumeration date
10/26/2017
Last updated
10/26/2017
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