Doctor Name: | OLGA JOHNSON |
NPI Number: | 1457620312 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | TSLP |
Business Practice Address: | 86 W Salt Mine Rd Camp Verde, AZ - 863227013 |
Business Phone Number: | 9285675253 |
Business Fax Number: | |
Mailing Address: | 1411 W University Heights Dr S, FLAGSTAFF |
State: | AZ |
Postal Code: | 860058921 |
Phone Number: | 9286992258 |
Fax Number: | |
NPI Enumeration Date: | 12/22/2011 |
NPI Last Update Date: | 02/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TSLP |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
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 |