Individual
MARLEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11408 LAKE SHERWOOD AVE N STE A, BATON ROUGE, LA 70816-0421
(225) 261-7143
(225) 250-1046
Mailing address
4812 APPLEWOOD RD, FORT WORTH, TX 76133-7404
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
78638
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/06/2018
Last updated
11/12/2021
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