MEDICARE: VALERIE JOHNSON MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	4262	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4262	OTHER	TN	STATE LICENSE

General Provider Information

NPI Number	:	1134668197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE JOHNSON MS, CCC-SLP

Provider Business Mailing Address
First Line	:	505 W BELL AVE
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-3405
Country	:	US
Telephone Number	:	678-977-2006
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 W BELL AVE
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-3405
Country	:	US
Telephone Number	:	678-977-2006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2017
Last Update Date	:	04/18/2017

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Directions to “ VALERIE JOHNSON MS, CCC-SLP” Practice Location

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