Carol A Johnson
Individual provider Active NPI Speech-Language Pathologist · Soldotna, AK
NPI 1700210796 · NPPES record last updated Aug 26, 2013
Key facts
- NPI
- 1700210796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 453 (AK)
- Practice address
- 35105 Kenai Spur Hwy Ste a
Soldotna, AK 99669-7658 - Phone
- (907) 260-7444
- Fax
- (907) 260-7400
- NPI assigned
- Aug 26, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 453 | AK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenai Kids Therapy Inc | Past | Accepting new patients | |
| Kenai Kids Therapy, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 453 | AK | Yes |
Addresses
Primary practice location
35105 Kenai Spur Hwy Ste a
Soldotna, AK 99669-7658
Mailing address
48584 Debra Cir
Kenai, AK 99611-9436
Phone (907) 260-7444
Other providers in Soldotna, AK
- Job Ready, Inc.
- John Nels Anderson MD
- John Nels Anderson, M.D.
- Bruce David Johnson
- Carol Johnson
- Heather Johnson
- Julie L Johnson
- Sandra Deniece Johnson
- Tara Johnson
- Stephen G Jolley
All providers in Soldotna, AK · Speech-Language Pathologist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.