Individual
DR. JEREMY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY. D.
Contact information
Practice address
3104 BLUE LAKE DR, VESTAVIA, AL 35243-2345
(205) 977-3003
Mailing address
3104 BLUE LAKE DR, VESTAVIA, AL 35243-2345
(205) 977-3003
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1741
AL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1741
AL
Other
Enumeration date
08/31/2010
Last updated
03/14/2012
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