Individual
MICHEAL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
285 HOLMES PITTMAN RD, FOXWORTH, MS 39483-3166
(601) 736-3111
(601) 444-5036
Mailing address
285 HOLMES PITTMAN RD, FOXWORTH, MS 39483-3166
(601) 736-3111
(601) 444-5036
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3987
MS
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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