NPI | 1760718902 |
---|---|
Former Name | DEANNA NICOLE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005329) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TN 0000006541) |
Enumeration Date | 2009-10-22 |
Last Update Date | 2022-10-26 |