| NPI | 1861816282 |
|---|---|
| Former Name | BETHANY AMBURN JOHNSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11115) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 106877) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2017-04-05 |