Individual
SHAUNDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 INDUSTRIAL PKWY, LAFAYETTE, LA 70508-8309
(337) 962-3699
Mailing address
101 BANDELIER DR, LAFAYETTE, LA 70508-1823
(337) 962-3699
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1194
LA
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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