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Individual

MISS TAMARA LEAANN JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW, LMAC

Contact information

Practice address
501 S NINNESCAH ST, PRATT, KS 67124-2838
(620) 672-7546
(620) 672-7148
Mailing address
501 S NINNESCAH ST, PRATT, KS 67124-2838
(620) 672-7546
(620) 672-7148

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LMAC271
KS
104100000X
Social Worker
Primary
LMSW10156
KS

Other

Enumeration date
04/19/2017
Last updated
04/19/2017
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