Provider Demographics
NPI:1891483251
Name:JOHNSON-KWOCHKA, ANNALEE VILEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNALEE
Middle Name:VILEN
Last Name:JOHNSON-KWOCHKA
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 1:125 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2868
Mailing Address - Country:US
Mailing Address - Phone:828-398-3601
Mailing Address - Fax:828-333-5465
Practice Address - Street 1:125 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2868
Practice Address - Country:US
Practice Address - Phone:828-398-3601
Practice Address - Fax:828-333-5465
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103580103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist