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NPI Code Detail

MEDICARE: BRANDI JOHNSON TODD

MEDICARE: BRANDI JOHNSON TODD
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 Pathologist4743SC

General Provider Information

NPI Number : 1831406057
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI JOHNSON TODD
Provider Business Mailing Address
First Line : PO BOX 309
Second Line :
City : MURRELLS INLET
State : SC
Zip : 29576-0309
Country : US
Telephone Number : 843-215-1905
Fax Number : 843-650-2236
Provider Business Practice Location Address
First Line : 9405 HIGHWAY 17 BYP
Second Line :
City : MURRELLS INLET
State : SC
Zip : 29576-9301
Country : US
Telephone Number : 843-215-1905
Fax Number : 843-650-2236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2010
Last Update Date : 09/09/2010

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Directions to “ BRANDI JOHNSON TODD ” Practice Location

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