Johnston, Sandra K

Johnston, Sandra K is an sole proprietor health care provider with primary practice located at 120 Wyldewood Dr #B202, Oshkosh WI 54904-8631. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Johnston, Sandra K can be contacted via phone (920) 479-8178.

Contact Information

Primary practice address
120 Wyldewood Dr #B202 Oshkosh WI 54904-8631
Phone: (920) 479-8178
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 4407-125 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15657-131 Wisconsin
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3184-57 Wisconsin

Profile Details

NPI number 1811299126
LBN Legal business name Johnston, Sandra K
Credentials PHD, LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 19th, 2010
Last updated Sep 2nd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811299126 NPPES
Wisconsin MEDICAID 100015347

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