Individual
DR. GLENN ROGER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
256 CONCORD AVE, CAMBRIDGE, MA 02138-1337
(617) 661-6098
Mailing address
1048 WALNUT ST, NEWTON HIGHLANDS, MA 02461-1249
(617) 661-6098
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1986
MA
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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