Provider Demographics
NPI:1275752644
Name:JOHNSTON, ANDREA MARIA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIA
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARIA
Other - Last Name:ARANEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2660 E WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286
Mailing Address - Country:US
Mailing Address - Phone:602-739-6825
Mailing Address - Fax:
Practice Address - Street 1:690 E. WARNER RD.
Practice Address - Street 2:SUITE 105
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296
Practice Address - Country:US
Practice Address - Phone:480-820-6366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist