Individual
MS. TIFFANY P JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
79 BLAKE ST, PRESQUE ISLE, ME 04769-2474
(207) 764-4101
Mailing address
PO BOX 308, PRESQUE ISLE, ME 04769-0308
(207) 764-4498
(207) 764-1912
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
ST1737
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432291999
—
ME
Enumeration date
09/20/2007
Last updated
05/07/2020
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