Individual
MRS. MARY-MARTHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN,APRN,BC
Contact information
Practice address
555 E CITY AVE, SUITE 210, BALA CYNWYD, PA 19004-1115
(610) 660-8338
(610) 660-8339
Mailing address
8218 WESTMINSTER RD, ELKINS PARK, PA 19027-1409
(215) 572-6326
(215) 885-2808
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN242205L
PA
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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