Individual
DR. DONALD LARRY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4001 HOME ST, CASTLE ROCK, CO 80108-2802
(303) 688-3174
Mailing address
2444 W WOLFENSBERGER RD, CASTLE ROCK, CO 80109-9635
(303) 909-5878
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1623
CO
103TA0700X
Adult Development & Aging Psychologist
1623
CO
103TB0200X
Cognitive & Behavioral Psychologist
1623
CO
103TC0700X
Clinical Psychologist
Primary
1623
CO
103TC2200X
Clinical Child & Adolescent Psychologist
1623
CO
103TF0000X
Family Psychologist
1623
CO
103TM1800X
Intellectual & Developmental Disabilities Psychologist
0393393
CO
103TS0200X
School Psychologist
0393393
CO
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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