Provider Demographics
NPI:1548572035
Name:JOHNSON, KAREN G (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:G
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 34TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1202
Mailing Address - Country:US
Mailing Address - Phone:202-821-2718
Mailing Address - Fax:202-582-0283
Practice Address - Street 1:2224 34TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1202
Practice Address - Country:US
Practice Address - Phone:202-821-2718
Practice Address - Fax:202-582-0283
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02939235Z00000X
DCSLP000323235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist