Basic Information
| Provider Information | |||||||||
| NPI: | 1720426331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | OLIVE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D., F-AAA, ABA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6015 FARRINGTON RD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275178154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194937980 | ||||||||
| FaxNumber: | 9194937985 | ||||||||
| Practice Location | |||||||||
| Address1: | 6015 FARRINGTON RD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275178154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194937980 | ||||||||
| FaxNumber: | 9194937985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2013 | ||||||||
| LastUpdateDate: | 03/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 10486 | NC | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.