Individual
STACEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 PERIWINKLE DR, BARNEGAT, NJ 08005-2064
(732) 642-1069
Mailing address
4 PERIWINKLE DR, BARNEGAT, NJ 08005-2064
(732) 642-1069
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
631979
NJ
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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