Individual
MELINDA MARIS JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. L.L.P. L.L.P.C.
Contact information
Practice address
5340 HOLIDAY TER, KALAMAZOO, MI 49009-2196
(269) 372-4140
(269) 372-0390
Mailing address
5340 HOLIDAY TER, KALAMAZOO, MI 49009-2196
(269) 372-4140
(269) 372-0390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401009761
MI
103TC1900X
Counseling Psychologist
6301011212
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0897457
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
06/16/2006
Last updated
07/14/2009
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