Johnson, Clarence

Johnson, Clarence is an sole proprietor health care provider with primary practice located at 1129 Morgan St. , Cleveland MS 38732. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Johnson, Clarence can be contacted via phone (662) 398-7575.

Contact Information

Primary practice address
1129 Morgan St. Cleveland MS 38732
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X S0851 Mississippi

Profile Details

NPI number 1710152178
LBN Legal business name Johnson, Clarence
Credentials CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 28th, 2008
Last updated Apr 28th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710152178 NPPES
Mississippi MEDICAID 0112761

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