Provider Demographics
NPI:1427362961
Name:JOHNSON, FAITH (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
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 1:5318 TRAIL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-4039
Mailing Address - Country:US
Mailing Address - Phone:713-927-1032
Mailing Address - Fax:713-434-1207
Practice Address - Street 1:7324 SOUTHWEST FWY STE 375
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2013
Practice Address - Country:US
Practice Address - Phone:713-771-8444
Practice Address - Fax:713-771-0977
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12652235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist