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Individual

PAULA TENPAS JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. CCC/SLP

Contact information

Practice address
600 YORK ST, MANITOWOC, WI 54220-6845
(920) 320-6850
(920) 682-1981
Mailing address
2300 WESTERN AVE, PO BOX 2170, MANITOWOC, WI 54221-2170
(920) 320-8667
(920) 320-8616

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
561-154
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42680200
WI
01
709070
T19 MANAGED HEALTH SERVIC
WI
Enumeration date
07/03/2006
Last updated
07/08/2007
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