Doctor Name: | COLLEEN KELLY JOHNSON |
NPI Number: | 1073506507 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 9127 |
Business Practice Address: | 111 Bedford Rd Suite B Bedford, TX - 760225222 |
Business Phone Number: | 8172858081 |
Business Fax Number: | 8172858508 |
Mailing Address: | 111 Bedford Rd, Suite B BEDFORD |
State: | TX |
Postal Code: | 760225222 |
Phone Number: | 8172858081 |
Fax Number: | 8172858508 |
NPI Enumeration Date: | 08/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 9127 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | TX |
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 |