Doctor Name: | PATRICIA MARIE JOHNSON |
NPI Number: | 1114361391 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 22005399A |
Business Practice Address: | 11650 Lantern Rd Suite 235 Fishers, IN - 460382993 |
Business Phone Number: | 3175768410 |
Business Fax Number: | 8886544116 |
Mailing Address: | 11650 Lantern Rd, Suite 235 FISHERS |
State: | IN |
Postal Code: | 460382993 |
Phone Number: | 3175768410 |
Fax Number: | 8886544116 |
NPI Enumeration Date: | 04/18/2013 |
NPI Last Update Date: | 04/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22005399A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |