Individual
PATRICIA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
11650 LANTERN RD, SUITE 235, FISHERS, IN 46038-2993
(317) 576-8410
(888) 654-4116
Mailing address
11650 LANTERN RD, SUITE 235, FISHERS, IN 46038-2993
(317) 576-8410
(888) 654-4116
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005399A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22005399A
INDIANA STATE LICENSE
IN
Enumeration date
04/18/2013
Last updated
04/18/2013
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