Organization
KIM L JOHNSON PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM L JOHNSON PH.D. (LICENSED PSYCHOLOGIST)
(480) 491-5501
Entity
Organization
Contact information
Practice address
1930 S ALMA SCHOOL RD, SUITE #B-214, MESA, AZ 85210-3064
(480) 491-5501
Mailing address
1930 S ALMA SCHOOL RD, SUITE #B-214, MESA, AZ 85210-3064
(480) 491-5501
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1796
AZ
103TA0700X
Adult Development & Aging Psychologist
1796
AZ
103TC2200X
Clinical Child & Adolescent Psychologist
1796
AZ
Other
Enumeration date
12/05/2008
Last updated
12/05/2008
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