Individual
BRENTLEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1106 FALCON CT, CARTERVILLE, IL 62918-1771
(870) 926-4319
Mailing address
1106 FALCON CT, CARTERVILLE, IL 62918-1771
(870) 926-4319
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
200968
AR
Other
Enumeration date
01/10/2019
Last updated
09/23/2021
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