Individual
DR. MICHAEL DEAN JOHNSON
Active
Individual
DR. MICHAEL DEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
30562
TX
103TC0700X
Clinical Psychologist
Primary
30562
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004GD
BLUE CROSS
TX
05
—
149851101
—
TX
01
—
231238
VALUE OPTIONS
TX
Enumeration date
11/17/2006
Last updated
06/19/2018
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