Individual
DR. CARLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
46 PRINCE ST STE 601, NEW HAVEN, CT 06519-1634
(203) 752-1726
(855) 451-0554
Mailing address
31 BROADWAY FL 2, NORTH HAVEN, CT 06473-2363
(203) 234-1324
(855) 476-0993
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000672
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000672
CT LICENSE
CT
01
—
15400058
CAQH
CT
Enumeration date
09/11/2017
Last updated
10/27/2021
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