SearchIdahoSpecialist

Deserae Johnson, LMT

NPI 1033537170 · on the registry since 2014 · sole proprietor

Practice

Address
1654 W Boise St
Kuna, ID 83634
Phone
(208) 409-0422

Registry record

Primary taxonomy
Specialist
174400000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2014-04-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho