| Doctor Name: | MRS. LINDA MARIE JOHNSON |
| NPI Number: | 1780832212 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS |
| License Number: | 602154 |
| Business Practice Address: | 1703 60th St Kenosha, WI - 53140 |
| Business Phone Number: | 2626584125 |
| Business Fax Number: | 2626582196 |
| Mailing Address: | 1000 Beverly Way, Aegis Therapies FORT SMITH |
| State: | AR |
| Postal Code: | 72919 |
| Phone Number: | 8778238375 |
| Fax Number: | 4792012703 |
| NPI Enumeration Date: | 09/09/2008 |
| NPI Last Update Date: | 09/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 602154 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| 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 |