Individual
ERIC BLAKE JOHNSTUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4864 E BASELINE RD STE 106, MESA, AZ 85206-4629
(480) 877-1486
Mailing address
289 W BALSAM DR, CHANDLER, AZ 85248-3960
(480) 353-8140
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-23630
AZ
Other
Enumeration date
01/23/2025
Last updated
01/23/2025
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