Provider Demographics
NPI:1598890139
Name:JOHNSON, BARBARA JEAN (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E LONGVIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-2105
Mailing Address - Country:US
Mailing Address - Phone:920-731-6477
Mailing Address - Fax:
Practice Address - Street 1:506 E LONGVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-2105
Practice Address - Country:US
Practice Address - Phone:920-731-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist