Individual
AQUILLA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4794 NW 49TH RD, TAMARAC, FL 33319-3281
(954) 815-6576
Mailing address
PO BOX 190495, FT LAUDERDALE, FL 33319-0495
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 9337
FL
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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