| NPI | 1750631057 |
|---|---|
| Former Name | TERESA L JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NH 1265) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NC 4778) |
| 103TC1900X Psychologist, Counseling (Licence: ID 203304) | |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2021-06-11 |