JOHANNA BOULT

SHREVEPORT, LA
NPI1164804423
Former NameJOHANNA WEDDLE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: LA  4477)
Enumeration Date2015-06-23
Last Update Date2015-06-23
Business Address
-- JOHANNA BOULT PhD
1450 CLAIBORNE AVE
SHREVEPORT, LA 71103-4204
Phone number: 318-813-2970
Mailing Address
-- JOHANNA BOULT PhD
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-813-2970
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