Individual
MRS. REBECCA L JOHNAON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH AND LANGUAGE
Contact information
Practice address
1300 S. COTTAGE GROVE, KIRKSVILLE, MO 63501-6350
(660) 665-4631
(660) 665-4631
Mailing address
1901 E.HAMILTON, KIRKSVILLE, MO 64501-3904
(660) 665-4631
(660) 665-3281
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
100354
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100534
DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION
MO
Enumeration date
07/19/2018
Last updated
07/19/2018
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