Individual
JILL K JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS-CCC/SLP
Contact information
Practice address
3472 N SANDPIPER DR, FAYETTEVILLE, AR 72704
(479) 442-6249
(479) 750-3539
Mailing address
521 MYSTIC RIVER TRL, FORT WORTH, TX 76131-4556
(479) 799-6251
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
107298
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841512944
—
AR
Enumeration date
02/17/2010
Last updated
08/28/2018
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