Individual
DR. JAURES PRESCOTT JOHNSTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
636 ASHURST RD, HAVERTOWN, PA 19083-5626
(484) 988-1625
Mailing address
636 ASHURST RD, HAVERTOWN, PA 19083-5626
(484) 988-1625
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS004050L
PA
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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