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Individual

MS. PEGGY LYN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
30 WINTER ST, SUITE 802, BOSTON, MA 02108-4720
(617) 426-0600
Mailing address
1245 ADAMS ST # B303, DORCHESTER, MA 02124-5799
(617) 905-1273

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
59013
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1221905
MA
Enumeration date
04/05/2006
Last updated
07/02/2014
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