Individual
SETH JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
2703 SE OTIS CORLEY DR, BENTONVILLE, AR 72712-3864
(917) 905-0139
Mailing address
2703 SE OTIS CORLEY DR, BENTONVILLE, AR 72712-3864
(917) 905-0139
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48450
AR
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203528721
—
AR
Enumeration date
11/14/2018
Last updated
01/09/2023
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