Provider Demographics
NPI:1720426331
Name:JOHNSON, PATRICIA OLIVE (AUD, F-AAA, ABA)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:OLIVE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AUD, F-AAA, ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 FARRINGTON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8154
Mailing Address - Country:US
Mailing Address - Phone:919-493-7980
Mailing Address - Fax:919-493-7985
Practice Address - Street 1:6015 FARRINGTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8154
Practice Address - Country:US
Practice Address - Phone:919-493-7980
Practice Address - Fax:919-493-7985
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10486231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist