Individual
MARTY LEE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP
Contact information
Practice address
1125 W SPRUCE ST, OLATHE, KS 66061-3123
(913) 782-2100
Mailing address
6000 LAMAR AVE, STE 130, MISSION, KS 66202-3234
(913) 831-2550
(913) 826-1589
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0059
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25895024
BCBS OF KC
KS
Enumeration date
07/03/2006
Last updated
07/08/2007
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