Individual
KIMBERLY ANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
593 NW YORK DR, BEND, OR 97703-7264
(971) 346-0355
Mailing address
593 NW YORK DR, BEND, OR 97703-7264
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18242
OR
235Z00000X
Speech-Language Pathologist
TSLP-4434
ID
235Z00000X
Speech-Language Pathologist
—
ID
Other
Enumeration date
09/03/2020
Last updated
09/05/2024
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