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General NPI Number Information
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NPI Number | 1215027685
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Entity Type | Individual
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Provider Name | CATHERINE VICKERS JOHNSON AUD, CCC-A
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 107 REGIONAL REHABILIATION CENTER FLORIDA STATE UNIVERSITY
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City | TALLAHASSEE
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State | FL
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Zip | 32306
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Country | US
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Telephone | 850-645-7303
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Fax |
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Provider Business Mailing Address
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Address Line | 2420 SHALLEY DR
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City | TALLAHASSEE
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State | FL
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Zip | 32309-3019
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Country | US
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Telephone | 850-893-5720
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY1287
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License Number State | FL
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