| Doctor Name: | DEANNA NICOLE JOHNSON |
| NPI Number: | 1760718902 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SPEECH LANGUAGE PATH |
| License Number: | 2202005329 |
| Business Practice Address: | 5286 Alexander Road Heartland Rehabilitation Services Of Virginia-dublin Dublin, VA - 24084 |
| Business Phone Number: | 5406746400 |
| Business Fax Number: | 5406746055 |
| Mailing Address: | 342 Virginia Avenue, Heartland Rehabilitation Services Of Virginia, Wythevil WYTHEVILLE |
| State: | VA |
| Postal Code: | 24382 |
| Phone Number: | 2762286200 |
| Fax Number: | 2762289175 |
| NPI Enumeration Date: | 10/22/2009 |
| NPI Last Update Date: | 10/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202005329 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| 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 |