Doctor Name: | MARIE JOHNSON |
NPI Number: | 1841546850 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SP0000004374 |
Business Practice Address: | 807 University Pkwy Lamb Hall, Room 361 Johnson City, TN - 376146500 |
Business Phone Number: | 4234394584 |
Business Fax Number: | 4234394607 |
Mailing Address: | 807 University Pkwy, Box 70403 JOHNSON CITY |
State: | TN |
Postal Code: | 376146500 |
Phone Number: | 4234394071 |
Fax Number: | 4234394060 |
NPI Enumeration Date: | 07/27/2012 |
NPI Last Update Date: | 07/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP0000004374 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |