Individual
DESERAE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
254 MERIDA DR, ANTHONY, NM 88021-8225
(575) 649-9327
Mailing address
254 MERIDA DR, ANTHONY, NM 88021-8225
(575) 649-9327
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
T-0173791
NM
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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