Provider Demographics
NPI:1083483606
Name:JOHNSTON, TASHA MARIE (LMBT)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:MARIE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 CELANESE RD.
Mailing Address - Street 2:SUITE 103- STUDIO 138
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732
Mailing Address - Country:US
Mailing Address - Phone:980-428-0984
Mailing Address - Fax:
Practice Address - Street 1:2685 CELANESE RD.
Practice Address - Street 2:SUITE 103- STUDIO 138
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732
Practice Address - Country:US
Practice Address - Phone:980-428-0984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20365225700000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist