Individual
PAMELA JOHSTONEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1190 N 900E, PROVO, UT 84601
(801) 422-7620
Mailing address
387 E 450 N, SPRINGVILLE, UT 84663-1582
(801) 422-8715
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1395213501
UT
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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