Staci Johnson, ED.S., NCSP

NPI #1306394010 in Logan, West Virginia

Provider Information

NPI Number: 1306394010
Entity Type: Individual
Name: Staci Johnson, ED.S., NCSP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - School
Credential: ED.S., NCSP
Enumeration Date: Sep 12, 2016
Last Updated: Sep 12, 2016

Practice Location

Address: 66 SCHOOL ST
Address 2: MONAVILLE
City: Logan
State: West Virginia
ZIP Code: 25601-9605
Phone: (304) 792-2089

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - School — School	103TS0200X	Primary

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