Individual
MR. DAVID JAMES JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4564 VOYAGEUR DR, ERIE, PA 16505-5422
(814) 866-2729
(814) 790-4122
Mailing address
4564 VOYAGEUR DR, ERIE, PA 16505
(814) 866-2729
(814) 790-4122
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-006787-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11925400
CAQH
—
01
—
215444
MEDICARE
PA
Enumeration date
12/04/2006
Last updated
01/22/2024
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