Individual
DIANE MARIE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
882 OAKMAN BLVD, DETROIT, MI 48238-3710
(313) 875-7601
Mailing address
2025 DUNHAM DR, ROCHESTER, MI 48306-4804
(248) 913-5290
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401017050
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184180465
—
MI
Enumeration date
02/12/2019
Last updated
11/14/2019
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