Individual
JOHANN NICHOLAS PREWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1726 KINGSLEY AVE, SUITE 12, ORANGE PARK, FL 32073-4463
(904) 269-6071
(904) 269-6642
Mailing address
3720 BEACH BLVD, JACKSONVILLE, FL 32207-3814
(904) 475-2039
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 4331
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY 4331
FL
Other
Enumeration date
06/24/2006
Last updated
08/23/2017
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