Provider Demographics
NPI:1437455292
Name:CHRISTINA JOHNSTON, MA, CCC-SLP
Entity Type:Organization
Organization Name:CHRISTINA JOHNSTON, MA, CCC-SLP
Other - Org Name:TIME 2 TALK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:217-299-1713
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62629-0314
Mailing Address - Country:US
Mailing Address - Phone:217-299-1713
Mailing Address - Fax:217-670-0305
Practice Address - Street 1:4505 BLACKWOLF RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-7872
Practice Address - Country:US
Practice Address - Phone:217-299-1713
Practice Address - Fax:217-670-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty