Individual
DR. KYLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., NCSP
Contact information
Practice address
11307 SUNSET HILLS RD STE B4, RESTON, VA 20190-5279
(410) 914-7795
Mailing address
1815 WATCH HOUSE CIR S, SEVERN, MD 21144-5015
(205) 999-1726
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005813
VA
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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