Individual
MR. CHRISTIAN K JOHSTONEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
91 CLARK FORK RD, HERON, MT 59844-9595
(406) 847-5095
(406) 847-5014
Mailing address
91 CLARK FORK RD # B, HERON, MT 59844-9595
(406) 847-5095
(406) 847-5014
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6052317-3601
UT
1041C0700X
Clinical Social Worker
Primary
SWP-LCSW-LIC7807
MT
Other
Enumeration date
02/27/2014
Last updated
03/24/2014
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