Most Relevant Information
Provider Data
| NPI Number: | 1003386509 |
| Provider Name: | SHANNON JOHNSON M.A., CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 13361 |
Most Important Dates
| Enumeration Date: | 11/28/2018 |
| Last Updated: | 11/28/2018 |
Provider Practice Location
2505 W SHAW AVE BLDG A
FRESNO
CA
937113334
Practice Location Phone/Fax
| Phone: | 5592289100 |
| Fax: | 5592289200 |
Provider Mailing Location
2505 W SHAW AVE BLDG A
FRESNO
CA
937113334
Provider Mailing Phone/Fax
| Phone: | 5592289100 |
| Fax: | 5592289200 |