Individual
KATRINA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 253-2413
Mailing address
16454 WICKIE RD, BANNISTER, MI 48807-9302
(989) 640-8521
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073588711
—
MI
Enumeration date
12/18/2018
Last updated
12/18/2018
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