Individual
MS. SARA C JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
500 OWNBY ST, LORDSBURG, NM 88045
(505) 542-9364
Mailing address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9500
(575) 523-1108
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3922
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34837574
—
NM
Enumeration date
04/09/2007
Last updated
05/18/2018
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