Individual
LAKEISHIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5342 BROADWAY AVE, SHREVEPORT, LA 71109
(318) 946-2487
Mailing address
5342 BROADWAY AVE, SHREVEPORT, LA 71109-7210
(318) 946-2487
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
LA
Other
Enumeration date
07/16/2016
Last updated
04/24/2017
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