Provider Demographics
NPI:1033637137
Name:JOHNSON, EMILY Z (SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:Z
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 BYRD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3011
Mailing Address - Country:US
Mailing Address - Phone:804-612-1947
Mailing Address - Fax:804-612-1955
Practice Address - Street 1:1701 BYRD AVENUE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230
Practice Address - Country:US
Practice Address - Phone:804-612-1947
Practice Address - Fax:804-612-1955
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist