Provider Demographics
NPI:1619124518
Name:JOHNSON-BATISTE, BRANDYE (MED, MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRANDYE
Middle Name:
Last Name:JOHNSON-BATISTE
Suffix:
Gender:F
Credentials:MED, MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 ACORN GLEN TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-6084
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2211 ACORN GLEN TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-6084
Practice Address - Country:US
Practice Address - Phone:337-319-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2022-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103688235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist