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Individual

AMANDA R JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17502 HAMILWOOD DR, HOUSTON, TX 77095-1118
(505) 330-8371
Mailing address
17502 HAMILWOOD DR, HOUSTON, TX 77095-1118

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
120815521
NM
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120815521
DRIVERS LICENSE NUMBER
NM
Enumeration date
02/09/2012
Last updated
08/13/2024
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