Provider Demographics
NPI:1346458338
Name:SCARIANO JOHNSON, SUNNY (MS)
Entity Type:Individual
Prefix:MRS
First Name:SUNNY
Middle Name:
Last Name:SCARIANO JOHNSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 GAUSE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4231
Mailing Address - Country:US
Mailing Address - Phone:985-649-9131
Mailing Address - Fax:985-649-9498
Practice Address - Street 1:2238 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4231
Practice Address - Country:US
Practice Address - Phone:985-649-9131
Practice Address - Fax:985-649-9498
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5367235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1623938Medicaid