Individual
BEVERLY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED CCC-SLP
Contact information
Practice address
710 CARPENTER FLETCHER RD, DURHAM, NC 27713-1940
(919) 544-9765
(919) 544-5654
Mailing address
710 CARPENTER FLETCHER RD, DURHAM, NC 27713-1940
(919) 544-9765
(919) 544-5654
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2411
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411715
—
NC
Enumeration date
11/10/2006
Last updated
07/09/2007
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