Doctor Name: | MR. STEPHEN ANDREW JOHNSON |
NPI Number: | 1407079098 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.,CCC,SLP |
License Number: | 05367 |
Business Practice Address: | 12650 Grey Eagle Ct Apt. 14 Germantown, MD - 208745318 |
Business Phone Number: | 5707065662 |
Business Fax Number: | |
Mailing Address: | 11260 Ivarea Rd, EDINBORO |
State: | PA |
Postal Code: | 164123520 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 05367 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
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 |