Individual
MRS. ANDREA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4310 NE 13TH TER, OAKLAND PARK, FL 33334-4708
(954) 829-2341
Mailing address
8221 SW 5TH ST, NORTH LAUDERDALE, FL 33068-2006
(954) 829-2341
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA12868
FL
235Z00000X
Speech-Language Pathologist
SZ4669
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000243400
—
FL
Enumeration date
10/28/2008
Last updated
07/13/2014
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