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Individual

MARK V.F. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
5110 12TH AVE, BROOKLYN, NY 11219-3424
(800) 275-3243
(800) 275-3671
Mailing address
5110 12TH AVE, BROOKLYN, NY 11219-3424
(800) 275-3243
(800) 275-3671

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017347-1
NY

Other

Enumeration date
10/20/2010
Last updated
10/20/2010
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