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General NPI Number Information
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NPI Number | 1659252211
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Entity Type | Individual
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Provider Name | SOPHIA RENE JOHNSON M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 301 DIVISION ST S
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City | NORTHFIELD
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State | MN
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Zip | 55057-2035
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Country | US
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Telephone | 507-205-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 519 SUMMIT LN
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City | DUNDAS
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State | MN
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Zip | 55019-4130
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Country | US
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Telephone | 952-693-3872
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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 | 14503393
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License Number State | MN
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