Individual
KADE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
212 W HAYDEN PARK RD, QUEEN CREEK, AZ 85243-6079
(480) 268-6875
Mailing address
212 W HAYDEN PARK RD, QUEEN CREEK, AZ 85243-6079
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4133795
AZ
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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