Provider Demographics
NPI:1881036648
Name:JOHNSON, YALONDA (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:YALONDA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803B COMPUTER DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6503
Mailing Address - Country:US
Mailing Address - Phone:910-305-6469
Mailing Address - Fax:919-791-3583
Practice Address - Street 1:3803B COMPUTER DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6503
Practice Address - Country:US
Practice Address - Phone:910-305-6469
Practice Address - Fax:919-791-3583
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10427235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist