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General NPI Number Information
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NPI Number | 1912629882
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Entity Type | Individual
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Provider Name | ABIGAIL JOHNS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1000 S MARSHALL ST
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City | LAKEWOOD
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State | CO
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Zip | 80226-4629
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Country | US
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Telephone | 951-294-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 536 STIRLING BRIDGE RD
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City | GROVETOWN
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State | GA
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Zip | 30813-5294
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Country | US
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Telephone | 470-429-1842
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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 | SLP.0004866
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License Number State | CO
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