NPI 1033537170

Deserae Lei Johnson, LMT

Practitioner Specialist Kuna, ID

Practice location

Address: 1654 W Boise St, Kuna, ID 83634-3137
Phone: (208) 409-0422

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence MAS-1035 (ID)

Other Specialist providers in Idaho →

Registry record

NPI: 1033537170
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Apr 2014
Record last updated: 5 Apr 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.