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1265976047
CHARLES JOHNSON
SHREVEPORT, LA
NPI
1265976047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-12-13
Last Update Date
2016-12-13
Business Address
-- CHARLES JOHNSON
1320 HARVARD AVE
SHREVEPORT, LA 71103-2521
Phone number: 318-294-1654
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Mailing Address
-- CHARLES JOHNSON
2605 BETTY ST
SHREVEPORT, LA 71108-5553
Phone number: 318-216-3748
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