Provider Demographics
NPI:1760924435
Name:JOHNSON, HANNAH ELIZABETH (MA)
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:ELIZABETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 SUNSET BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3496
Mailing Address - Country:US
Mailing Address - Phone:803-479-3535
Mailing Address - Fax:
Practice Address - Street 1:2999 SUNSET BLVD
Practice Address - Street 2:STE 100
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3496
Practice Address - Country:US
Practice Address - Phone:803-479-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-13
Last Update Date:2016-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist