Roger Dale Johnston Jr.
Community/Behavioral Health in Kihei, HI. Individual provider (NPI-1).
NPI number1750718979
StatusActive
Last updated in NPPESNov 2, 2023
Details
- NPI
- 1750718979
- Entity type
- Individual (NPI-1)
- Name
- Mr. Roger Dale Johnston Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 2, 2013
- Certification date
- Nov 2, 2023
- Last updated
- Nov 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
160 Keonekai Rd Apt 27-206Kihei, HI 96753-7145
Phone 801-592-6432
Mailing address
160 Keonekai Rd Apt 27-206Kihei, HI 96753-7145
Phone 801-592-6432
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