Provider Demographics
NPI:1720154875
Name:JOHNSON, AARON LEROY (AUD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:LEROY
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MAIN AVE SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-7200
Mailing Address - Country:US
Mailing Address - Phone:256-841-0930
Mailing Address - Fax:256-841-0931
Practice Address - Street 1:1900 MAIN AVE SW
Practice Address - Street 2:SUITE 1
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-7200
Practice Address - Country:US
Practice Address - Phone:256-841-0930
Practice Address - Fax:256-841-0931
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL916A237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist