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Individual

DR. AUDREY GILL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1 VA CTR, AUGUSTA, ME 04330-6719
(207) 623-8411
Mailing address
1 VA CTR, AUGUSTA, ME 04330-6719

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1591
ME
103TH0100X
Health Service Psychologist

Other

Enumeration date
06/02/2015
Last updated
07/11/2019
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