Individual
MS. ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
239 CAUSEWAY ST, MEDFIELD, MA 02052-2900
(617) 331-1762
Mailing address
239 CAUSEWAY ST, MEDFIELD, MA 02052-2900
(617) 331-1762
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6979
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W06278
BLUE SHIELD
MA
Enumeration date
06/05/2007
Last updated
07/08/2007
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