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Contact Information

JACQUELINE JOHNSON
2107 GARDENWOOD CT
ATLANTA, GA30349
 Phone: 404-857-8639
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Service

103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JACQUELINE JOHNSON · (Female)

NPI # 1811160740
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2008
Last updated 08/01/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • GA Medicaid 372320984B
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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