Individual
TARA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1774 CENTRE ST, RAPID CITY, SD 57703-4029
(605) 863-1833
Mailing address
1774 CENTRE ST, RAPID CITY, SD 57703-4029
(605) 863-1833
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
545-PROV
SD
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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