Johnson, Carissa

Johnson, Carissa is an individual health care provider with primary practice located at 5207 Granite Ridge Dr , Lithia FL 33547-1845. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Johnson, Carissa can be contacted via phone (813) 220-2730.

Contact Information

Primary practice address
5207 Granite Ridge Dr Lithia FL 33547-1845
Phone: (813) 220-2730
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA7318 Florida

Profile Details

NPI number 1952499212
LBN Legal business name Johnson, Carissa
Credentials M.S., C.C.C.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Oct 3rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952499212 NPPES
Florida MEDICAID 812018800
Florida Other S2755
Florida MEDICAID 889202400

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