Individual
DOUGLASS DAVID JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
111 FRONT ST, WYALUSING, PA 18853-7505
(570) 746-6003
(570) 746-2011
Mailing address
PO BOX 174, 114 MAIN STREET, WYALUSING, PA 18853-0174
(570) 746-6003
(570) 746-2011
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW000365E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW000365E
SOCIAL WORK
PA
Enumeration date
11/21/2006
Last updated
10/31/2024
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