Individual
LISA JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5325 GREENWOOD AVE, SUITE 201, WEST PALM BEACH, FL 33407-2452
(561) 882-6375
(561) 881-0970
Mailing address
5325 GREENWOOD AVE, SUITE 201, WEST PALM BEACH, FL 33407-2452
(561) 882-6375
(561) 881-0970
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
FL
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811796900
—
FL
Enumeration date
03/09/2007
Last updated
08/31/2011
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