Johnson, Jessica

Johnson, Jessica is an individual health care provider with primary practice located at 602 Vonderburg Dr Suite 201, Brandon FL 33511-5900. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Johnson, Jessica can be contacted via phone (813) 653-1149.

Contact Information

Primary practice address
602 Vonderburg Dr Suite 201 Brandon FL 33511-5900
Phone: (813) 653-1149
Fax: (813) 654-6644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA12617 Florida
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SZ5988 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X SA12617 Florida

Profile Details

NPI number 1689919730
LBN Legal business name Johnson, Jessica
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2012
Last updated May 6th, 2014 - about 12 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 1689919730 NPPES
Florida MEDICAID 010947100
Florida MEDICAID 007336000

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