Rahn A Johnson, SLPA

Individual provider Active NPI Speech-Language Assistant · Vail, AZ

NPI 1619603479 · NPPES record last updated Jul 25, 2022

Key facts

NPI
1619603479
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
SLPA14007 (AZ)
Practice address
12984 E Wild Horse Corral Dr
Vail, AZ 85641-2537
Phone
(520) 222-4239
NPI assigned
Jul 25, 2022
Sex
Male
Sole proprietor
No

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
SLPA14007AZMDSpeech-Language Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA14007 AZ Yes

Addresses

Primary practice location

12984 E Wild Horse Corral Dr
Vail, AZ 85641-2537

Mailing address

12984 E Wild Horse Corral Dr
Vail, AZ 85641-2537
Phone (520) 222-4239

Other providers in Vail, AZ

All providers in Vail, AZ · Speech-Language Assistant in Arizona

Sources for this page

Verify at the official NPI Registry.