Individual
AMANDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1123 1ST AVE E STE 200, NEWTON, IA 50208-3981
(641) 792-4012
(641) 791-0697
Mailing address
1123 1ST AVE E STE 200, NEWTON, IA 50208-3981
(641) 792-4012
(641) 791-0697
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001202
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069468
—
IA
Enumeration date
10/13/2010
Last updated
01/04/2022
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