Doctor Name: | MISS DEBORAH SUE JOHNSON |
NPI Number: | 1508006909 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.C.D., CCC-SLP |
License Number: | 2290 |
Business Practice Address: | 510 E Stoner Ave Shreveport, LA - 711014243 |
Business Phone Number: | 3182218411 |
Business Fax Number: | |
Mailing Address: | 4110 Scenic Dr, SHREVEPORT |
State: | LA |
Postal Code: | 711197123 |
Phone Number: | 3186173458 |
Fax Number: | |
NPI Enumeration Date: | 02/24/2009 |
NPI Last Update Date: | 02/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2290 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
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 |