Provider Demographics
NPI:1922067602
Name:JOHNSTON, VALERIE LEIGH (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:LEIGH
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4400 PERRY LANE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133
Mailing Address - Country:US
Mailing Address - Phone:817-346-6515
Mailing Address - Fax:
Practice Address - Street 1:4763 BARWICK DR
Practice Address - Street 2:#103 OVERTON SPEECH AND LANGUAGE CENTER
Practice Address - City:FORTH WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132
Practice Address - Country:US
Practice Address - Phone:817-294-8408
Practice Address - Fax:817-294-8411
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10222OtherTEXAS DEPT OF STATE HEALT