Doctor Name: | CHRISTINE JOHNSON |
NPI Number: | 1043434061 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 180-002794 |
Business Practice Address: | 505 W University Ave Suite 2 Champaign, IL - 618203915 |
Business Phone Number: | 2175507708 |
Business Fax Number: | |
Mailing Address: | 505 Wet University Avenue, Suite 2 CHAMPAIGN |
State: | IL |
Postal Code: | 618203915 |
Phone Number: | 2175507708 |
Fax Number: | |
NPI Enumeration Date: | 04/12/2007 |
NPI Last Update Date: | 06/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 180-002794 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |