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1306393897
TRAVISTINE JOHNSON
SHREVEPORT, LA
NPI
1306393897
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-09-01
Last Update Date
2016-09-01
Business Address
-- TRAVISTINE JOHNSON
2605 BETTY ST
SHREVEPORT, LA 71108-5553
Phone number: 318-216-3748
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Mailing Address
-- TRAVISTINE JOHNSON
2605 BETTY ST
SHREVEPORT, LA 71108-5553
Phone number: 318-216-3748
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