Individual
MR. PHILIP RUSSELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFTA
Contact information
Practice address
1437 MILITARY CUTOFF RD STE 200, WILMINGTON, NC 28403-3638
(301) 471-1537
Mailing address
6113 SAND RIDGE AVE, WILMINGTON, NC 28409-7601
(301) 471-1537
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
12310A
NC
Other
Enumeration date
05/07/2009
Last updated
10/29/2021
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