Individual
CRYSTAL ROSE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
715 LAKE ST, OAK PARK, IL 60301-1422
(708) 209-8987
(708) 434-5586
Mailing address
845 W BELMONT AVE APT 4, CHICAGO, IL 60657-4462
(773) 844-2732
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009543
IL
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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