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General NPI Number Information
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NPI Number | 1730202227
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Entity Type | Individual
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Provider Name | TERRENCE JOSEPH JOHNSON PH.D
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 802 W KING ST SUITE P
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City | OWOSSO
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State | MI
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Zip | 48867-2100
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Country | US
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Telephone | 989-723-1120
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Fax | 989-729-6506
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Provider Business Mailing Address
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Address Line | 4890 OJIBWAY TRL
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City | OWOSSO
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State | MI
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Zip | 48867-9782
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Country | US
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Telephone | 989-723-1120
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Fax | 989-729-6506
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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 | 6301002671
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101005346
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License Number State | MI
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