Provider Demographics
NPI:1336492644
Name:JOHNSON, SARAH CORRINE (AUD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CORRINE
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 1:4904 E ROSA PARKS PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4041
Mailing Address - Country:US
Mailing Address - Phone:605-521-8750
Mailing Address - Fax:
Practice Address - Street 1:4904 E ROSA PARKS PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-4041
Practice Address - Country:US
Practice Address - Phone:605-521-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD403-A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist