Individual
DR. MICHAEL BRUCE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2406 SUNSET VISTA CIR, SPICEWOOD, TX 78669-2094
(512) 228-2126
Mailing address
2406 SUNSET VISTA CIR, SPICEWOOD, TX 78669-2094
(512) 228-2126
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
13-21P
AR
103TC1900X
Counseling Psychologist
13-21P
AR
103TC1900X
Counseling Psychologist
PSY003246
GA
103TE1100X
Exercise & Sports Psychologist
13-21P
AR
103TE1100X
Exercise & Sports Psychologist
PSY003246
GA
103TP2701X
Group Psychotherapy Psychologist
PSY003246
GA
Other
Enumeration date
01/12/2009
Last updated
10/23/2022
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