Michelle Johnson
Psychologist, Health Service in Hawthorne, FL. Individual provider (NPI-1).
NPI number1962019935
StatusActive
Last updated in NPPESSep 24, 2020
Details
- NPI
- 1962019935
- Entity type
- Individual (NPI-1)
- Name
- Michelle Johnson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 24, 2020
- Certification date
- Sep 24, 2020
- Last updated
- Sep 24, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TH0100X | Psychologist, Health Service | 236912 | FL | Yes |
Practice location
22513 Se 61st AveHawthorne, FL 32640-3640
Phone 352-234-5738
Mailing address
22513 Se 61st AveHawthorne, FL 32640-3640
Phone 352-234-5738
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