Individual
JENNIFER S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED. CCC-SLP
Contact information
Practice address
CHARLOTTESVILLE CITY SCHOOLS, 1562 DAIRY RD, CHARLOTTESVILLE, VA 22903-2290
(434) 245-2400
Mailing address
1572 STONEY CREEK DR, CHARLOTTESVILLE, VA 22902-7238
(302) 242-4428
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005697
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004909976
—
VA
Enumeration date
02/16/2009
Last updated
11/23/2020
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