Individual
ALEXA JOHANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
335 OLD RAIL RD, BLOOMINGDALE, GA 31302-4025
(912) 421-0140
Mailing address
119 RUBY TRL, GUYTON, GA 31312-7001
(912) 856-2282
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET004380
GA
Other
Enumeration date
08/19/2025
Last updated
08/19/2025
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