Individual
BENJAMIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3019 SEA MARSH RD, FERNANDINA BEACH, FL 32034-5055
(401) 829-1023
(401) 445-0228
Mailing address
3019 SEA MARSH RD, FERNANDINA BEACH, FL 32034-5055
(401) 829-1023
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS00654
RI
Other
Enumeration date
10/13/2006
Last updated
04/30/2024
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