Individual
MADISON WHITEHURST JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
31 STAFFORD AVE, STAFFORD, VA 22554-7246
(540) 658-6000
Mailing address
14370 MADRIGAL DR, WOODBRIDGE, VA 22193-5959
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202009815
VA
235Z00000X
Speech-Language Pathologist
2204000350
VA
Other
Enumeration date
08/05/2019
Last updated
01/19/2021
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