Provider Demographics
NPI:1508147315
Name:JOHNSON, ALAINA WALLER (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALAINA
Middle Name:WALLER
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:CHRISTINE
Other - Last Name:WALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:433 METAIRIE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4324
Mailing Address - Country:US
Mailing Address - Phone:985-249-5225
Mailing Address - Fax:985-249-5223
Practice Address - Street 1:433 METAIRIE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4333
Practice Address - Country:US
Practice Address - Phone:985-249-5225
Practice Address - Fax:985-249-5223
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6464231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist