Provider Demographics
NPI:1609503770
Name:JOHNSTON, KEIRSTIN FEINAUER (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KEIRSTIN
Middle Name:FEINAUER
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9866 SMART RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-6362
Mailing Address - Country:US
Mailing Address - Phone:859-609-2278
Mailing Address - Fax:
Practice Address - Street 1:301 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:NEW VIENNA
Practice Address - State:OH
Practice Address - Zip Code:45159
Practice Address - Country:US
Practice Address - Phone:859-609-2278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.14949235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist