Provider Demographics
NPI:1154606630
Name:JOHNS, CATHERINE C (MS, SLP-L)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:C
Last Name:JOHNS
Suffix:
Gender:F
Credentials:MS, SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6891 TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:PAVILION
Mailing Address - State:NY
Mailing Address - Zip Code:14525-9724
Mailing Address - Country:US
Mailing Address - Phone:585-409-4948
Mailing Address - Fax:
Practice Address - Street 1:6891 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:PAVILION
Practice Address - State:NY
Practice Address - Zip Code:14525-9724
Practice Address - Country:US
Practice Address - Phone:585-409-4948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist