Provider Demographics
NPI:1427299791
Name:JOHNSON, NORMA J (PHD)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:J
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 1:91 TAYLOR HILL RD
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:MA
Mailing Address - Zip Code:01351-9511
Mailing Address - Country:US
Mailing Address - Phone:413-237-8581
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:#217
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3109
Practice Address - Country:US
Practice Address - Phone:413-237-8581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2103103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical