Doctor Name: | ANGELA JOHNSON |
NPI Number: | 1093172884 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 15644 |
Business Practice Address: | 611 N Broad St Lampasas, TX - 765501105 |
Business Phone Number: | 5125563588 |
Business Fax Number: | |
Mailing Address: | 191 County Road 417, GOLDTHWAITE |
State: | TX |
Postal Code: | 768443618 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/25/2016 |
NPI Last Update Date: | 01/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 15644 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |