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MISS MELISSA SUE JOHNSON BASLPA
Speech-Language Assistant >> Specialist/Technologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1811078900
Individual Registrant:MISS MELISSA SUE JOHNSON BASLPA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4 JACKSON STREET NE FT WALTON BEACH, FL 32578 US
Tel: 850-862-7227 Fax: 850-862-2421
Tel: 850-862-7227 Fax: 850-862-2421
Contact information for business:
540 GARDEN OAKS COVE NICEVILLE, FL 32578 US
Tel: 850-862-7227 Fax: 850-862-2421
Tel: 850-862-7227 Fax: 850-862-2421
Registration Information:
NPI: 1811078900
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2355S0801X | Speech, Language and Hearing Service Providers Specialist/Technologist Speech-Language Assistant | FL | SI 1269 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
