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LANETA CHANELLE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DT

Contact information

Practice address
7445 ROOSEVELT RD APT 206-B, FOREST PARK, IL 60130-2555
(773) 850-5543
Mailing address
7445 ROOSEVELT RD APT 206-B, FOREST PARK, IL 60130-2555
(773) 850-5543

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
05/10/2022
Last updated
05/10/2022
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