Individual
LISA DIANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1812 JEWELLA AVE APT 3203, SHREVEPORT, LA 71109-2033
(318) 759-9405
Mailing address
1812 JEWELLA AVE APT 3203, SHREVEPORT, LA 71109-2033
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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