Individual
RUSSELL JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-SLP
Contact information
Practice address
1200 SUNNYSIDE AVE, LAWRENCE, KS 66045-7600
(785) 864-4690
(785) 864-5094
Mailing address
1200 SUNNYSIDE AVE, 2101 HAWORTH HALL, LAWRENCE, KS 66045
(785) 864-4690
(785) 864-5094
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3856
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14175399
ASHA
MD
01
—
3856
KDADS LICENSE
KS
Enumeration date
10/17/2017
Last updated
10/17/2017
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