Individual
DR. FREDERICK VINCENT JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
68 N MAIN ST, CARVER, MA 02330-1128
(508) 866-5000
Mailing address
68 N MAIN ST, CARVER, MA 02330-1128
(508) 866-5000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6678
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
859839
MA. LIC. HEALTH CARE PROV
MA
Enumeration date
12/30/2005
Last updated
07/08/2007
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