Provider Demographics
NPI:1811084593
Name:JOHNSON, DAWN MICHELLE (PHD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:JOHNSON
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 1:444 N MAIN ST
Mailing Address - Street 2:CENTER FOR TRAUMATIC STRESS - AMB BLDG SUITE 420
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-3110
Mailing Address - Country:US
Mailing Address - Phone:330-379-5094
Mailing Address - Fax:330-379-5095
Practice Address - Street 1:444 N MAIN ST
Practice Address - Street 2:CENTER FOR TRAUMATIC STRESS - AMB BLDG SUITE 420
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-3110
Practice Address - Country:US
Practice Address - Phone:330-379-5094
Practice Address - Fax:330-379-5095
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5988103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist