Provider Demographics
NPI:1487730057
Name:JOHNSON, MAURA ANN (MS,CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BEACH RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-2210
Mailing Address - Country:US
Mailing Address - Phone:603-244-8223
Mailing Address - Fax:
Practice Address - Street 1:118 BEACH RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-2210
Practice Address - Country:US
Practice Address - Phone:603-244-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH562235Z00000X
MESP2860235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist