Individual
RONALD BRUCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
336 LODI ST, LODI, WI 53555-1418
(608) 592-2080
(608) 592-7120
Mailing address
336 LODI ST, LODI, WI 53555-1418
(608) 592-2080
(608) 592-7120
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2177-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39127800
—
WI
Enumeration date
06/22/2006
Last updated
03/18/2013
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