Individual
MRS. LESLIE MARTIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S, CCC-SLP
Contact information
Practice address
604 BUCKSHOT CT, STATESBORO, GA 30461-4496
(912) 764-7833
(912) 764-7833
Mailing address
604 BUCKSHOT CT, STATESBORO, GA 30461-4496
(912) 764-7833
(912) 764-7833
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP002048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000885497A
—
GA
Enumeration date
08/01/2006
Last updated
07/09/2007
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