Individual
MARIE A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
156 S DOSSETT DR, JOHNSON CITY, TN 37614-1702
(423) 439-4355
(423) 439-4607
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-4355
(423) 439-4607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP0000004374
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12146389
ASHA
TN
05
—
1511884
—
TN
01
—
SP0000004374
ST LICENSE
TN
Enumeration date
07/27/2012
Last updated
01/18/2024
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