Individual
DR. SUZANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
ATLANTA VA HEALTH CARE SYSTEM, 1670 CLAIRMONT RD, DECATUR, GA 30033
(404) 321-6111
Mailing address
2630 TALLEY ST UNIT 320, DECATUR, GA 30030-5347
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2018034563
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018034563
STATE OF MISSOURI PROFESSIONAL REGISTRATION (PSYCHOLOGIST)
MO
Enumeration date
10/09/2018
Last updated
10/09/2018
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