Provider Demographics
NPI:1548440357
Name:JOHNSON, KARA ROCHELLE (MS, CFY-SLP)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:ROCHELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9122 N HELENA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-2047
Mailing Address - Country:US
Mailing Address - Phone:816-500-6710
Mailing Address - Fax:
Practice Address - Street 1:8630 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2471
Practice Address - Country:US
Practice Address - Phone:816-420-9417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090118155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist