| NPI | 1366919359 |
|---|---|
| Former Name | LAURA ANN JOHNSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CO60588531) |
| Enumeration Date | 2018-10-27 |
| Last Update Date | 2018-10-27 |