| NPI | 1457991358 |
|---|---|
| Former Name | TRACI LYNN JOHNSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 7918) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: KS 9167156576) |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2023-10-16 |