Provider Demographics
NPI:1346509023
Name:JOHNSON, MICHAEL H (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 752
Mailing Address - Street 2:2230 CRYSTAL AVE APT 31
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45839-0752
Mailing Address - Country:US
Mailing Address - Phone:419-672-8730
Mailing Address - Fax:
Practice Address - Street 1:309 EAST MOREHEAD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202
Practice Address - Country:US
Practice Address - Phone:704-887-4409
Practice Address - Fax:866-231-5080
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-3310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist