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Individual

DEBRA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4257 SW 42ND ST, REDMOND, OR 97756-6977
(541) 224-8837
Mailing address
1400 EXECUTIVE PKWY STE 260, EUGENE, OR 97401-7121
(541) 224-8837

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3606
OR
103TF0200X
Forensic Psychologist
Primary
103TH0100X
Health Service Psychologist

Other

Enumeration date
01/09/2024
Last updated
01/09/2024
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