Individual
MARY BETH JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
900 STRAITS TPKE, D, MIDDLEBURY, CT 06762-2800
(203) 270-5575
(203) 883-0365
Mailing address
900 STRAITS TPKE, D, MIDDLEBURY, CT 06762-2800
(203) 270-5575
(203) 883-0365
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1439
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004093697
—
CT
Enumeration date
06/15/2006
Last updated
04/17/2013
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