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NPI Code Detail

MEDICARE: SAMANTHA JOHNSON M.S., CF-SLP

MEDICARE: SAMANTHA JOHNSON M.S., CF-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
1235Z00000XSpeech-Language Pathologist2204001355VA

General Provider Information

NPI Number : 1295574952
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA JOHNSON M.S., CF-SLP
Provider Business Mailing Address
First Line : 42945 HEATHERTON CT
Second Line :
City : ASHBURN
State : VA
Zip : 20147-4014
Country : US
Telephone Number : 703-389-4852
Fax Number :
Provider Business Practice Location Address
First Line : 21631 RIDGETOP CIR STE 225
Second Line :
City : STERLING
State : VA
Zip : 20166-4289
Country : US
Telephone Number : 571-207-8850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2024
Last Update Date : 05/22/2024

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