Doctor Name: | MARY CAROLINE JOHNSON |
NPI Number: | 1235193699 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 0941 |
Business Practice Address: | 1101 Veterans Dr 126-cdd Lexington, KY - 405022235 |
Business Phone Number: | 8592814972 |
Business Fax Number: | |
Mailing Address: | 3356 Grasmere Dr, LEXINGTON |
State: | KY |
Postal Code: | 405034020 |
Phone Number: | 8592234805 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0941 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
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 |