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Individual

JOHNNA AVERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
41 CAPE NEDDICK RD, YORK, ME 03909-6132
(207) 450-6529
Mailing address
41 CAPE NEDDICK RD, YORK, ME 03909-6132
(207) 450-6529

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1114
NH
235Z00000X
Speech-Language Pathologist
SP1348
ME

Other

Enumeration date
01/15/2010
Last updated
01/15/2010
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