Individual
MS. NICOLE KRISTEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
204 RESOURCE LN, WINDER, GA 30680-8361
(678) 963-0694
(888) 547-4008
Mailing address
204 RESOURCE LN, WINDER, GA 30680-8361
(678) 963-0694
(888) 547-4008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ5470
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003183165A
—
GA
05
—
004036600
—
FL
Enumeration date
07/05/2011
Last updated
02/07/2017
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