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1780030890
SHAVESHA LALETTE JOHNSON
SHREVEPORT, LA
NPI
1780030890
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X
Enumeration Date
2016-05-06
Last Update Date
2016-05-06
Business Address
-- SHAVESHA LALETTE JOHNSON MHS
1717 MARSHALL ST
SHREVEPORT, LA 71101-4139
Phone number: 318-226-9942
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Mailing Address
-- SHAVESHA LALETTE JOHNSON MHS
400 JOHN WESLEY BLVD APT 38
BOSSIER CITY, LA 71112-2299
Phone number: 318-560-3093
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