| Doctor Name: | TYREASEA ANICHA JOHNSON-MASON |
| NPI Number: | 1003250101 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | SP012833 |
| Business Practice Address: | 2250 Chapel Ave W Suite 100 Cherry Hill, NJ - 080022051 |
| Business Phone Number: | 8564829000 |
| Business Fax Number: | 8564821159 |
| Mailing Address: | 2250 Chapel Ave W, Suite 100 CHERRY HILL |
| State: | NJ |
| Postal Code: | 080022051 |
| Phone Number: | 8564829000 |
| Fax Number: | 8564821159 |
| NPI Enumeration Date: | 04/19/2013 |
| NPI Last Update Date: | 01/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | SP012833 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |