| NPI | 1083036578 |
|---|---|
| Former Name | JESSICA ANNE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL sa15873) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00613900) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2023-05-05 |