Doctor Name: | NENA ELISE JOHNSON |
NPI Number: | 1265465124 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6465 |
Business Practice Address: | 530 E 2nd St Duluth, MN - 558051913 |
Business Phone Number: | 2187865360 |
Business Fax Number: | |
Mailing Address: | 530 E 2nd St, DULUTH |
State: | MN |
Postal Code: | 558051913 |
Phone Number: | 2187865360 |
Fax Number: | |
NPI Enumeration Date: | 07/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 6465 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
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 |