Individual
LESLI K JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 BLUE LINE DR, ATHENS, OH 45701-2325
(740) 592-5689
Mailing address
17 BLUE LINE DR, ATHENS, OH 45701-2325
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5414
OH
Other
Enumeration date
02/27/2006
Last updated
07/08/2007
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