Provider Demographics
NPI:1982782447
Name:JOHNSON, JOANNE P (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:P
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 1:22331 TREE HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8801
Mailing Address - Country:US
Mailing Address - Phone:713-391-5309
Mailing Address - Fax:
Practice Address - Street 1:22331 TREE HOUSE LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8801
Practice Address - Country:US
Practice Address - Phone:713-391-5309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1840969-01Medicaid
TX1840969-02Medicaid
TX8J2714Medicare PIN
TX1840969-02Medicaid