Individual
MRS. LAURA ANNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP, BCS-F
Contact information
Practice address
3536 TALLYHO LN, MADISON, WI 53705-2127
(608) 217-8960
(608) 238-8342
Mailing address
3536 TALLYHO LN, MADISON, WI 53705-2127
(608) 217-8960
(608) 238-8342
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4152-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4152-154
WISCONSIN LICENSE
WI
Enumeration date
06/13/2018
Last updated
06/13/2018
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