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Individual

JASON JOHNSTONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A., LPA

Contact information

Practice address
313 WALNUT ST, SUITE 111, WILMINGTON, NC 28401-4067
(910) 368-9981
Mailing address
313 WALNUT ST, SUITE 111, WILMINGTON, NC 28401-4067
(910) 368-9981

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4645
NC

Other

Enumeration date
01/17/2016
Last updated
12/01/2016
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