| Doctor Name: | AMANDA LANE JOHNSTON |
| NPI Number: | 1720356595 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | |
| Business Practice Address: | 320 Custer Road Richardson, TX - 75080 |
| Business Phone Number: | 9724909055 |
| Business Fax Number: | 9724909058 |
| Mailing Address: | 320 Custer Road, RUCHARDSON |
| State: | TX |
| Postal Code: | 75080 |
| Phone Number: | 9724909055 |
| Fax Number: | 9724909058 |
| NPI Enumeration Date: | 12/08/2011 |
| NPI Last Update Date: | 05/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| 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 |