Most Relevant Information
Provider Data
| NPI Number: | 1003420910 |
| Provider Name: | SHOMA JOHNSON MS, CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 14302844 |
Most Important Dates
| Enumeration Date: | 09/08/2020 |
| Last Updated: | 09/08/2020 |
Provider Practice Location
3506 169TH ST APT C1
FLUSHING
NY
113581841
Practice Location Phone/Fax
| Phone: | 6786221933 |
| Fax: |
Provider Mailing Location
3506 169TH ST APT C1
FLUSHING
NY
113581841
Provider Mailing Phone/Fax
| Phone: | 6786221933 |
| Fax: |