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1588291454
AWILDA VEGA JOHNSTON
FULTON, NY
NPI
1588291454
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NY P104680)
Enumeration Date
2020-03-23
Last Update Date
2020-03-23
Business Address
AWILDA VEGA JOHNSTON LPMFT
92 N. 2ND ST. #100
FULTON, NY 13069
Phone number: 315-326-3555
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Mailing Address
AWILDA VEGA JOHNSTON LPMFT
913 W THOMAS ST
ROME, NY 13440-2539
Phone number: 845-800-6299
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