Individual
MRS. DEIDRA MCGIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCP
Contact information
Practice address
1102 S. ROUSE, PITTSBURG, KS 66762
(620) 231-5310
(620) 231-9893
Mailing address
1102 S. ROUSE, PITTSBURG, KS 66762
(620) 231-5310
(620) 231-9893
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
LCP - 269
KS
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TF0000X
Family Psychologist
LCP - 269
KS
Other
Enumeration date
08/22/2007
Last updated
10/23/2013
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