| Doctor Name: | MISS MELISSA SUE JOHNSON |
| NPI Number: | 1811078900 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BASLPA |
| License Number: | SI 1269 |
| Business Practice Address: | 4 Jackson Street Ne Ft Walton Beach, FL - 32578 |
| Business Phone Number: | 8508627227 |
| Business Fax Number: | 8508622421 |
| Mailing Address: | 540 Garden Oaks Cove, NICEVILLE |
| State: | FL |
| Postal Code: | 32578 |
| Phone Number: | 8508627227 |
| Fax Number: | 8508622421 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | SI 1269 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |