Individual
AMY FOWLER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5970 FAIRVIEW RD STE 412, CHARLOTTE, NC 28210-2105
(704) 222-1150
(704) 362-1170
Mailing address
5970 FAIRVIEW RD STE 412, CHARLOTTE, NC 28210-2105
(704) 222-1150
(704) 362-1170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000812
—
NC
Enumeration date
02/20/2007
Last updated
06/25/2021
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