Organization
JOHNSTON: SPEECH-LANGUAGE PATHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA ANNE JOHNSTON MS, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(607) 206-6542
Entity
Organization
Contact information
Practice address
3129 E RIVER RD, NICHOLS, NY 13812-3224
(607) 206-6542
Mailing address
3129 E RIVER RD, NICHOLS, NY 13812-3224
(607) 206-6542
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
014024
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014024
SLP LICENSE
NY
Enumeration date
06/22/2013
Last updated
08/02/2013
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