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MARK H JOHNSON PHD

Clinical Neuropsychologist

Great Falls, Montana

Provider NPI: 1932100518

Provider Information:
 MARK H JOHNSON PHD
Gender: M
Not Sole Proprietor

Practice Location:
400 15TH AVE S STE 205  GREAT FALLS, MT 59405 US
Tel: (40-6) -731-8888  Fax: 406-731-8876

Business Mailing Address:
400 15TH AVE S STE 205  GREAT FALLS, MT 59405 US
Tel: (40-6) -731-8888  Fax: 406-731-8876

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
Clinical
MT198
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MT198

Other Provider Identifiers:

IssuerNumberStateType
000005501MT04
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS MT - Page 1



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