Provider Demographics
NPI:1114270477
Name:THOMPSON-HOLLANDS, JOHANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:
Last Name:THOMPSON-HOLLANDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SOUTH HUNTINGTON AVE
Mailing Address - Street 2:NATIONAL CENTER FOR PTSD (116B-4)
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:857-364-2311
Mailing Address - Fax:
Practice Address - Street 1:150 SOUTH HUNTINGTON AVE
Practice Address - Street 2:NATIONAL CENTER FOR PTSD (116B-4)
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:857-364-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10616-PY-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical