Provider Demographics
NPI:1821586777
Name:JOHNSON, BRIANNA M (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23269
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76702-3269
Mailing Address - Country:US
Mailing Address - Phone:254-399-8255
Mailing Address - Fax:
Practice Address - Street 1:601 W LOOP 340
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-6840
Practice Address - Country:US
Practice Address - Phone:254-399-8255
Practice Address - Fax:254-235-3408
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist