Individual
DR. TISHA M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2255 CUMBERLAND PKWY SE, BUILDING 600, SUITE 150, ATLANTA, GA 30339-4515
(404) 419-7895
(404) 419-7891
Mailing address
PO BOX 950032, ATLANTA, GA 30377-2032
(404) 419-7895
(404) 419-7891
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003640
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135556B
—
GA
Enumeration date
06/22/2007
Last updated
08/19/2016
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