Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 129 | SC |
NPI | 1093979957 |
---|---|
Provider Name | Dr. Alan Haynes Johnson |
First Address | Mt Pleasant, SC 29464-4600 |
Second Address | Mt Pleasant, SC 29464-4600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 10/07/2008 |