Provider Demographics
NPI:1912628587
Name:JOHNSTON, GRACE MARGARET
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:MARGARET
Last Name:JOHNSTON
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 1:7025 WAKE FORREST DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-1744
Mailing Address - Country:US
Mailing Address - Phone:512-560-2213
Mailing Address - Fax:
Practice Address - Street 1:517 VIA AVENIDA
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3176
Practice Address - Country:US
Practice Address - Phone:972-290-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist