MEDICARE: KALEIGH-CLARE JOHNSON ARLINT

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

General Provider Information

NPI Number	:	1245016179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEIGH-CLARE JOHNSON ARLINT

Provider Business Mailing Address
First Line	:	641 CARRIAGE HILL RD STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-6546
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 CENTERVILLE TPKE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-6847
Country	:	US
Telephone Number	:	757-648-2200
Fax Number	:

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

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	09/06/2023

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