Provider Information for 1083368310
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DANIELLE RENEE JOHNSTON LPC
Sex: Female
NPI: 1083368310
Last Updated: 2025-01-25
Certification Date: 2025-01-25
Certification Date: 2025-01-25
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1083368310 | ||||||||||||
| Enumeration Date | 2022-02-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1660 PALMETTO PALM DR MYRTLE BEACH, SC 29579-7088 United States Phone: 843-333-6011 | Fax: | ||||||||||||
| Primary Practice Address | 1033 SHINE AVE STE F MYRTLE BEACH, SC 29577-1501 United States Phone: 843-936-7202 | Fax: | ||||||||||||
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