Individual
RENNAE I JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
400 15TH AVE S STE 205, GREAT FALLS, MT 59405-4375
(406) 731-8888
(406) 731-8876
Mailing address
400 15TH AVE S STE 205, GREAT FALLS, MT 59405-4375
(406) 731-8888
(406) 731-8876
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
196
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0493103
—
MT
Enumeration date
08/02/2005
Last updated
09/07/2023
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