Provider Demographics
NPI:1326332081
Name:JOHNSON, STEPHANIE R (AUD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9777 N 91ST ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5087
Mailing Address - Country:US
Mailing Address - Phone:480-451-0220
Mailing Address - Fax:
Practice Address - Street 1:21803 N SCOTTSDALE RD STE 125B
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7445
Practice Address - Country:US
Practice Address - Phone:480-515-0200
Practice Address - Fax:480-515-0207
Is Sole Proprietor?:No
Enumeration Date:2011-05-30
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist