Individual
MR. KENNETH ROGER JOHNSON
Active
Individual
MR. KENNETH ROGER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1023
OH
103TC0700X
Clinical Psychologist
1023
OH
103TC2200X
Clinical Child & Adolescent Psychologist
1023
OH
103TF0000X
Family Psychologist
1023
OH
103TH0100X
Health Service Psychologist
1023
OH
103TM1800X
Intellectual & Developmental Disabilities Psychologist
1023
OH
103TS0200X
School Psychologist
Primary
1023
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253854
—
OH
Enumeration date
03/31/2007
Last updated
09/11/2025
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