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Individual

DR. RAUSHANNAH N. JOHNSON-VERWAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY. D.

Contact information

Practice address
3915 CASCADE RD SW, SUITE T-90, ATLANTA, GA 30331-8512
(678) 973-2491
(404) 745-8485
Mailing address
130 WYNFIELD WAY SW, ATLANTA, GA 30331-6837
(757) 879-0639
(404) 745-8485

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003324
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY003324
GEORGIA PROFESSIONAL LICENSE
GA
Enumeration date
10/06/2009
Last updated
06/18/2012
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