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Individual

MISS MELISSA SUE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BASLPA

Contact information

Practice address
4 JACKSON STREET NE, FT WALTON BEACH, FL 32578
(850) 862-7227
(850) 862-2421
Mailing address
540 GARDEN OAKS COVE, NICEVILLE, FL 32578
(850) 862-7227
(850) 862-2421

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI 1269
FL

Other

Enumeration date
10/17/2006
Last updated
07/08/2007
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