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Individual
TRACY CAMILLE JOHNSON
Active
Individual
TRACY CAMILLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP, CLC
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
352442
—
235Z00000X
Speech-Language Pathologist
Primary
117491
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117491
TDLR- SLP
TX
01
—
1414916
ASHA- CCC
—
01
—
352442
ALPP-CLC
—
Enumeration date
10/28/2021
Last updated
09/24/2025
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