Provider Demographics
NPI:1881335818
Name:JOHNSON, CAROL A
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474-3435
Mailing Address - Country:US
Mailing Address - Phone:207-825-3697
Mailing Address - Fax:
Practice Address - Street 1:19 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ORRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04474-3435
Practice Address - Country:US
Practice Address - Phone:207-825-3697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist