Doctor Name: | MRS. STEPHANIE MARIE JOHNSON |
NPI Number: | 1689076390 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA,CCC-SLP |
License Number: | 7101000349 |
Business Practice Address: | 5103 W Pierson Rd Suite #3 Flint, MI - 485041395 |
Business Phone Number: | 8104231076 |
Business Fax Number: | 8103912968 |
Mailing Address: | 5473 Moceri Ln, GRAND BLANC |
State: | MI |
Postal Code: | 484394369 |
Phone Number: | 8104231076 |
Fax Number: | |
NPI Enumeration Date: | 09/24/2014 |
NPI Last Update Date: | 09/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7101000349 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |