Individual
BROOKE D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 2ND ST SE, MINOT, ND 58701
(701) 857-4400
Mailing address
215 2ND ST SE, MINOT, ND 58701
(856) 435-1777
(856) 435-0696
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1225
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1458821
—
ND
Enumeration date
01/14/2013
Last updated
09/16/2022
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