Individual
DR. RONN MARK JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
603 HEMLOCK ST STE 2C-3, BROOKINGS, OR 97415-9424
(541) 661-6479
(541) 412-7087
Mailing address
PO BOX 4245, BROOKINGS, OR 97415-0064
(541) 661-6479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1567
OR
103TC0700X
Clinical Psychologist
Primary
PSY18784
CA
Other
Enumeration date
05/25/2007
Last updated
07/10/2023
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