Provider Demographics
NPI:1154033447
Name:JOHNSON, DARIA K (SLP)
Entity type:Individual
Prefix:MS
First Name:DARIA
Middle Name:K
Last Name:JOHNSON
Suffix:
Gender:
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 OLINVILLE AVE APT 10G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-7442
Mailing Address - Country:US
Mailing Address - Phone:212-380-6597
Mailing Address - Fax:
Practice Address - Street 1:60 E WILLOW ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1438
Practice Address - Country:US
Practice Address - Phone:973-921-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist