Individual provider · Type 1 NPI

Rae A. Johnson

Developmental Therapist · Centralia, IL

NPI number 1669691044 Active

Practice location

299 Swan
Centralia, IL 62801

Mailing address

301 S Washington St
Salem, IL 62881-3028

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1669691044

Rae A. Johnson's National Provider Identifier is 1669691044, issued on Apr 24, 2007. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Centralia, IL. The record was last updated on Jul 8, 2007.