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General NPI Number Information
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NPI Number | 1528031119
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Entity Type | Individual
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Provider Name | CYNTHIA R JOHNSON PHD
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Gender | Female
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-448-6440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100165
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City | GAINESVILLE
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State | FL
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Zip | 32610-0165
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Country | US
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Telephone | 352-273-6617
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Fax | 352-273-6156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PS006135L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY9377
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License Number State | FL
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