Individual
ERIC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCH ASSOCIATE
Contact information
Practice address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6362
Mailing address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TS0200X
School Psychologist
Primary
A0078
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609550001
—
MD
05
—
609550002
—
MD
05
—
609550004
—
MD
Enumeration date
04/14/2014
Last updated
06/28/2016
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