Individual
MRS. TRACIE LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
6304 KOOSA DR, MARION, MS 39342-9458
(205) 317-7757
Mailing address
6304 KOOSA DR, MARION, MS 39342-9458
(205) 317-7757
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3156
MS
Other
Enumeration date
07/24/2008
Last updated
07/24/2008
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