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General NPI Number Information
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NPI Number | 1386911261
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Entity Type | Individual
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Provider Name | KASEY COLLEEN JOHNSON MS
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Gender | Female
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 134 SENECA ST
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City | HORNELL
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State | NY
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Zip | 14843-1324
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Country | US
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Telephone | 607-324-1303
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Fax | 607-324-6418
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Provider Business Mailing Address
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Address Line | 33 DENISON PKWY W
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City | CORNING
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State | NY
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Zip | 14830-2613
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Country | US
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Telephone | 607-937-3200
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 030165-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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