Individual
BROOKE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
209 W COLLEGE ST, FARMINGTON, MO 63640-2427
(573) 701-1370
Mailing address
209 W COLLEGE ST, FARMINGTON, MO 63640-2427
(573) 701-1370
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2011027678
MO
235Z00000X
Speech-Language Pathologist
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—
Other
Enumeration date
06/07/2012
Last updated
08/08/2019
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