Individual
CHERYL ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1500 E WOODROW WILSON AVE, 116A2, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
5305 RED FOX RD, JACKSON, MS 39211-4627
(601) 362-4471
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
29-419
MS
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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