Individual
JALISSA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2503 10TH ST, ALEXANDRIA, LA 71302-5929
(318) 880-8370
Mailing address
2503 10TH ST, ALEXANDRIA, LA 71302-5929
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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