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Individual

MRS. MARY HART-JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C, PMHNP-BC

Contact information

Practice address
2241M TACKETTS MILL DR, WOODBRIDGE, VA 22192-3029
(571) 777-0970
(571) 777-0960
Mailing address
2241M TACKETTS MILL DR, WOODBRIDGE, VA 22192-3029
(571) 777-0970
(571) 777-0960

Taxonomy

Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
0024167384
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1225221815
NPPES
VA
Enumeration date
08/27/2007
Last updated
07/20/2020
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