Individual
DONETTA GUILLORY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3651 MAIN STREET, ZACHARY, LA 70791-0770
(225) 209-0850
(888) 620-5988
Mailing address
PO BOX 770, ZACHARY, LA 70791-0770
(225) 209-0850
(888) 620-5988
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10148
LA
1041C0700X
Clinical Social Worker
Primary
10148
LA
Other
Enumeration date
10/13/2008
Last updated
10/12/2012
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