Individual
MR. ROY ALAN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.I.S.A.C
Contact information
Practice address
4041 N. CENTRAL AVE, BUILDING C, PHOENIX, AZ 85012-3133
(602) 279-5262
(602) 279-5390
Mailing address
4041 N. CENTRAL AVE, BUILDING C, PHOENIX, AZ 85012-3133
(602) 279-5262
(602) 279-5390
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11403
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC11403
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910217
—
AZ
Enumeration date
07/17/2007
Last updated
09/05/2014
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