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General NPI Number Information
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NPI Number | 1821235102
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Entity Type | Organization
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Legal Business Name | JOHNSON & ASSOCIATES, PC
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 48685 BEAVER CREEK DR
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City | PLYMOUTH
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State | MI
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Zip | 48170-3382
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Country | US
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Telephone | 734-453-3799
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Fax | 866-275-9190
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Provider Business Mailing Address
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Address Line | 48685 BEAVER CREEK DR
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City | PLYMOUTH
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State | MI
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Zip | 48170-3382
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Country | US
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Telephone | 734-453-3799
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Fax | 866-275-9190
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL A JOHNSON
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Credential | PH.D.
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Telephone | 734-453-3799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101000434
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301000908
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License Number State | MI
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