Individual
SUSAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
353 AMBROSE CREEK DR, SUGAR HILL, GA 30518-7870
(770) 235-4582
Mailing address
353 AMBROSE CREEK DR, SUGAR HILL, GA 30518-7870
(770) 235-4582
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004972
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000940486C
—
GA
Enumeration date
09/20/2006
Last updated
01/05/2009
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