Individual
MR. TOMMIE EARL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLMSW
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
405300000X
Prevention Professional
Primary
680115877
MI
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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