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Gwendolyn Johnson

Rehabilitation Practitioner in Pasadena, CA. Individual provider (NPI-1).

NPI number1891061925
StatusActive
Last updated in NPPESMar 22, 2012

Details

NPI
1891061925
Entity type
Individual (NPI-1)
Name
Gwendolyn Johnson
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 22, 2012
Last updated
Mar 22, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225400000X Rehabilitation Practitioner––Yes

Practice location

1007 N Lake Ave
Pasadena, CA 91104-4521

Phone 626-808-9746

Mailing address

2403 El Molino Ave
Altadena, CA 91001-2315

Phone 626-390-3877

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