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Mrs. Deserae Lei Johnson, LMT
Specialist in Kuna, Idaho
NPI 1033537170

Deserae Lei Johnson is a Specialist based in Kuna, ID. Deserae Lei Johnson practices in Kuna, ID and has the professional credentials of LMT. The NPI Number for Deserae Lei Johnson is 1033537170 and holds a License No. MAS-1035 (Idaho).

The current practice location address for Deserae Lei Johnson is 1654 W Boise St, Kuna, ID and can be reached out via phone at 208-409-0422.

Location: 1654 W Boise St, Kuna, ID, 83634-3137
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033537170
Provider Name
Deserae Lei Johnson
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
1654 W Boise St, Kuna, ID, 83634-3137
Phone Number
208-409-0422
Fax Number
Provider Enumeration Date
04/05/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1654 W Boise St
City
Kuna
State
Idaho
Zip
83634-3137
Phone Number
208-409-0422
Fax Number
person
Provider Business Mailing Address Details
Address
1654 W Boise St
City
Kuna
State
Idaho
Zip
83634-3137
Phone Number
208-409-0422
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MAS-1035 (Idaho)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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