Individual
DR. KIM L. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1930 S ALMA SCHOOL RD, SUITE NUMBER B-214, MESA, AZ 85210-3064
(480) 491-5501
Mailing address
1930 S ALMA SCHOOL RD, SUITE NUMBER B-214, MESA, AZ 85210-3064
(480) 491-5501
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1796
AZ
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1796
AZ
Other
Enumeration date
08/22/2006
Last updated
07/10/2007
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