Individual
DR. BETH A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
161 W WISCONSIN AVE, PEWAUKEE, WI 53072-3467
(262) 695-8857
(262) 695-8879
Mailing address
N75W23310 N RIDGEVIEW CIR, SUSSEX, WI 53089-2063
(262) 820-1628
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2297-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39790300
—
WI
Enumeration date
06/29/2006
Last updated
07/08/2007
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