Individual
MARY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
68 S 600 E, SALT LAKE CITY, UT 84102-1007
(801) 428-3243
Mailing address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(385) 200-0110
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
UT
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
Primary
F25-127874
UT
Other
Enumeration date
05/13/2020
Last updated
08/13/2026
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