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General NPI Number Information
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NPI Number | 1871865162
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Entity Type | Individual
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Provider Name | MAUREEN P JOHNSON MA
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Gender | Female
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 01/06/2023
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Provider Practice Location Address
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Address Line | 7710 NW 71ST CT STE 206
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City | TAMARAC
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State | FL
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Zip | 33321-2931
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Country | US
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Telephone | 954-549-4481
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Fax | 954-549-4481
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Provider Business Mailing Address
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Address Line | 11577 NW 44TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-7153
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Country | US
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Telephone | 954-549-4481
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Fax | 954-549-4481
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 20301
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License Number State | FL
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