Doctor Name: | MR. THOMAS D. JOHNSON |
NPI Number: | 1083636336 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | 0728C |
Business Practice Address: | 206 Rescia Ave Rainbow City, AL - 359065933 |
Business Phone Number: | 2564137154 |
Business Fax Number: | 2564137813 |
Mailing Address: | 3445 S Valley Rd, SOUTHSIDE |
State: | AL |
Postal Code: | 359078110 |
Phone Number: | 2564428382 |
Fax Number: | 2564137813 |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0728C |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |