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1801248448
MARY JOHNSON
LAKE CHARLES, LA
NPI
1801248448
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-07-07
Last Update Date
2016-07-07
Business Address
-- MARY JOHNSON
803 W BAYOU PINES DR STE D
LAKE CHARLES, LA 70601-7096
Phone number: 337-437-8458
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Mailing Address
-- MARY JOHNSON
717 BURLEY ST APT A
PICAYUNE, MS 39466-5101
Phone number:
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