Individual
MS. CRYSTAL ELAINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
500 N MAIN ST, RANDOLPH, MA 02368-6700
(617) 306-6828
Mailing address
116 RIVER ST APT 14, MATTAPAN, MA 02126-2944
(617) 953-0669
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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