Provider Demographics
NPI:1932277381
Name:JOHNSON, MARGARET WALDRUP (MT-BC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:WALDRUP
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 LAKE SHORE RD N
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-9199
Mailing Address - Country:US
Mailing Address - Phone:704-489-0817
Mailing Address - Fax:
Practice Address - Street 1:4504 LAKE SHORE RD N
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-9199
Practice Address - Country:US
Practice Address - Phone:704-489-0817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist