Most Relevant Information
Provider Data
| NPI Number: | 1003408121 |
| Provider Name: | JOSIE LYN JOHNSON SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/10/2021 |
| Last Updated: | 02/10/2021 |
Provider Practice Location
5250 HERITAGE PKWY
FORT WAYNE
IN
468351061
Practice Location Phone/Fax
| Phone: | 2602096279 |
| Fax: |
Provider Mailing Location
3003 GRANDVIEW DR
FORT WAYNE
IN
468042821
Provider Mailing Phone/Fax
| Phone: | 2602247032 |
| Fax: |