Provider Demographics
NPI:1144398454
Name:JOHNSON, ASHLEY BROOKE (DO)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BROOKE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1840 WOODMOOR DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9083
Mailing Address - Country:US
Mailing Address - Phone:719-622-6522
Mailing Address - Fax:719-622-6520
Practice Address - Street 1:1840 WOODMOOR DR STE 102
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9083
Practice Address - Country:US
Practice Address - Phone:719-622-6522
Practice Address - Fax:719-622-6520
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00612402084P0800X
OHAG70991312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry