Provider Demographics
NPI:1356069942
Name:KURIAPPILLY, JOHNSON
Entity type:Individual
Prefix:MR
First Name:JOHNSON
Middle Name:
Last Name:KURIAPPILLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2247 DOGWOOD CRESCENT
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:ON
Mailing Address - Zip Code:N6K 5C6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2247 DOGWOOD CRESCENT
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:ON
Practice Address - Zip Code:N6K 5C6
Practice Address - Country:CA
Practice Address - Phone:905-483-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty