Individual
JENNIFER LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4711 N 23RD AVE, PHOENIX, AZ 85015-3478
(602) 242-2442
Mailing address
5134 W SPUR DR, PHOENIX, AZ 85083-1281
(623) 580-0898
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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