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Individual

DR. RONALD R JOHNSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
2587 RAVENHILL DR, FAYETTEVILLE, NC 28303-5451
(910) 323-1543
(910) 485-1257
Mailing address
2587 RAVENHILL DR, FAYETTEVILLE, NC 28303-5451
(910) 323-1543
(910) 485-1257

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3148
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046G5
BCBS
NC
01
2212866
CIGNA
NC
01
344242
MANAGED HEALTH NETWORK
NC
05
6107230
NC
01
D8114
MEDCOST
NC
Enumeration date
06/16/2005
Last updated
07/09/2007
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