Cindy D Johnson Brown, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Chipley, FL

NPI 1013125152 · NPPES record last updated Apr 20, 2023

Key facts

NPI
1013125152
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SA 8630 (FL)
Practice address
2102B Mud Hill Rd
Chipley, FL 32428-3874
Phone
(407) 625-5111
Fax
(850) 635-0299
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SA 8630FLMDSpeech-Language Pathologist
SA8630FLMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193400000X SINGLE SPECIALTY GROUP
235Z00000X SA8630 FL
Speech-Language Pathologist 235Z00000X SA 8630 FL Yes

Addresses

Primary practice location

2102B Mud Hill Rd
Chipley, FL 32428-3874

Mailing address

PO Box 295
Wausau, FL 32463-0295
Phone (407) 625-5111

Other providers in Chipley, FL

All providers in Chipley, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.