Individual
MARJORIE MARIE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
486 11TH ST, IDAHO FALLS, ID 83404-4851
(208) 206-1483
Mailing address
486 11TH ST, IDAHO FALLS, ID 83404-4851
(208) 206-1483
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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