Provider Demographics
NPI:1124185962
Name:JOHNSON, RACHEL LEE (CEIS CIMI)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CEIS CIMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PATTISON ST
Mailing Address - Street 2:APT 1F
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351
Mailing Address - Country:US
Mailing Address - Phone:781-982-9989
Mailing Address - Fax:
Practice Address - Street 1:1115 WEST CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-559-0473
Practice Address - Fax:508-427-5361
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist