Individual
MS. SALLY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
905 N MEADOW ST, MOSCOW, ID 83843-9584
(208) 882-3381
Mailing address
1620 SW SUMMIT CT., PULLMAN, WA 99163
(509) 332-5106
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00002773
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01108824
ASHA MEMBER
—
01
—
LL00002773
LISCENSE SPEECH-LANGUAGE
WA
Enumeration date
01/05/2007
Last updated
07/08/2007
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