Doctor Name: | DR. DOUGLAS PAUL JOHNSON |
NPI Number: | 1710016498 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 825 |
Business Practice Address: | 5721 Cutler Health Ctr Orono, ME - 044695721 |
Business Phone Number: | 2075811392 |
Business Fax Number: | 2075814975 |
Mailing Address: | 5721 Cutler Health Ctr, ORONO |
State: | ME |
Postal Code: | 044695721 |
Phone Number: | 2075811392 |
Fax Number: | 2075814975 |
NPI Enumeration Date: | 03/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 825 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |