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NPI Code Detail

MEDICARE: KATE JOHNSON MS CF SLP

MEDICARE:   KATE  JOHNSON  MS 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 Pathologist20119026457MO

General Provider Information

NPI Number : 1366080244
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATE JOHNSON MS CF SLP
Provider Business Mailing Address
First Line : 567 N AND SOUTH RD APT C
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63130-3939
Country : US
Telephone Number : 314-380-3088
Fax Number :
Provider Business Practice Location Address
First Line : 567 N AND SOUTH RD APT C
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63130-3939
Country : US
Telephone Number : 314-380-3088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2019
Last Update Date : 12/11/2019

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Directions to “ KATE JOHNSON MS CF SLP” Practice Location

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