National Provider Identifier
Kristina Everly Johnson, MS CCC-SLP
Kristina Everly Johnson, MS CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Jamestown, NY and a listed phone number of (716) 338-0668.
Profile Overview
- NPI
- 1023551082
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- November 23, 2016
- Last Updated
- June 24, 2021
Practice Location
- 774 Fairmount Ave
- Jamestown, NY 14701-2609
Phone: (716) 338-0668
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1023551082
- Entity Type
- Individual
- Last Name
- Johnson
- First Name
- Kristina
- Middle Name
- Everly
- Name Prefix
- Mrs.
- Credential
- MS CCC-SLP
- Provider Other Last Name
- Hodnett
- Provider Other First Name
- Kristina
- Provider Other Middle Name
- Everly
- Provider Other Name Prefix Text
- Mrs.
- Provider Other Credential Text
- MS CCC-SLP
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 774 Fairmount Ave
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-2609
- Mailing Country
- US
- Practice Street Address
- 774 Fairmount Ave
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-2609
- Practice Country
- US
- Practice Phone
- (716) 338-0668
- Enumeration Date
- November 23, 2016
- Last Updated
- June 24, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- June 24, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)