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General NPI Number Information
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NPI Number | 1013730043
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Entity Type | Individual
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Provider Name | TESS JOHNSON AUD
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 128 CHESTERFIELD COMMONS RD E
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1440
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Country | US
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Telephone | 636-778-1168
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 PALM RIDGE CT
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City | SAINT LOUIS
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State | MO
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Zip | 63146-4418
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 2022005698
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License Number State | MO
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