Individual
EBONY S JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5693 DEER VALLEY TRL, ANTIOCH, TN 37013-4261
(615) 513-6840
Mailing address
5693 DEER VALLEY TRL, ANTIOCH, TN 37013-4261
(615) 513-6840
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3934
TN
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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