Organization
WAKE PEDIATRIC SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA JOHNSON MS, CCC-SLP (SPEECH PATHOLOGIST/OWNER)
(919) 593-8104
Entity
Organization
Contact information
Practice address
1157 EXECUTIVE CIR STE B1, CARY, NC 27511-4579
(919) 593-8104
(919) 882-8110
Mailing address
1157 EXECUTIVE CIR STE B1, CARY, NC 27511-4579
(919) 593-8104
(919) 882-8110
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
5439
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7413900
—
NC
Enumeration date
04/03/2014
Last updated
04/03/2014
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