Individual
BIANCA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
610 GAYLE ST, FREDERICKSBURG, VA 22405-1324
(540) 368-2559
Mailing address
137 BARNSWALLOW LN, STAFFORD, VA 22556-6229
(571) 737-5713
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007047
VA
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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