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General NPI Number Information
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NPI Number | 1952912180
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Entity Type | Individual
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Provider Name | LAURA JOHNSON CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 6900 S ORANGE BLOSSOM TRL STE 102
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City | ORLANDO
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State | FL
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Zip | 32809-5734
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Country | US
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Telephone | 321-445-1286
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Fax |
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Provider Business Mailing Address
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Address Line | 5231 VIA HACIENDA CIR APT 117
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City | ORLANDO
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State | FL
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Zip | 32839-5303
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Country | US
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Telephone | 214-773-2858
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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 | SA17666
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License Number State | FL
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