| Doctor Name: | JESSICA ANNE JOHNSTON |
| NPI Number: | 1295062529 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CCC-SLP |
| License Number: | SL008036 |
| Business Practice Address: | 3129 E River Rd Nichols, NY - 138123224 |
| Business Phone Number: | 6072066542 |
| Business Fax Number: | |
| Mailing Address: | 3129 E River Rd, NICHOLS |
| State: | NY |
| Postal Code: | 138123224 |
| Phone Number: | 6072066542 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2009 |
| NPI Last Update Date: | 11/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | SL008036 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |