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Kathryn Johnson

Clinic/Center in Mount Dora, FL. Organization (NPI-2).

NPI number1114005667
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1114005667
Entity type
Organization (NPI-2)
Legal business name
Kathryn Johnson
Organization subpart
No
Enumeration date
Nov 1, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

4400 N Highway 19a
Suite 4
Mount Dora, FL 32757-2032

Phone 352-988-4181

Mailing address

5655 S Orange Ave
Orlando, FL 32809-4289

Phone 407-895-4100 · Fax 407-422-4492

Authorized official

Kathryn Johnson
Psychosocial Clinician II
3529884181

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