Provider Demographics
NPI:1669548491
Name:WORKMAN, JOHANNA RACHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:RACHAEL
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 FLATBUSH AVE
Mailing Address - Street 2:#18
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4336
Mailing Address - Country:US
Mailing Address - Phone:914-208-7394
Mailing Address - Fax:
Practice Address - Street 1:2105 FLATBUSH AVE
Practice Address - Street 2:#18
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4336
Practice Address - Country:US
Practice Address - Phone:914-208-7394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical