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General NPI Number Information
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NPI Number | 1508492620
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Entity Type | Individual
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Provider Name | TAMMY LEE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 03/20/2020
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Last Update Date | 03/20/2020
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Provider Practice Location Address
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Address Line | 1151 E MAIN ST STE B
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City | TORRINGTON
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State | CT
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Zip | 06790-3983
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Country | US
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Telephone | 860-626-8450
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Fax | 860-626-8452
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Provider Business Mailing Address
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Address Line | 12 COLONY DR
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City | WINSTED
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State | CT
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Zip | 06098-1809
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Country | US
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Telephone | 860-480-8131
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Fax | 860-626-8452
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 000426
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License Number State | CT
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