Individual
NICHOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC/SLP-L
Contact information
Practice address
610 LINCOLN ST, CENTERVILLE, SD 57014-2040
(605) 563-2291
Mailing address
30437 UNIVERSITY RD, CENTERVILLE, SD 57014-6536
(605) 563-2291
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015-SLP
SD
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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