Individual
CRYSTAL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2053 GAUSE BLVD E, SLIDELL, LA 70461-5449
(985) 649-1001
Mailing address
39110 TAYLOR ST, PEARL RIVER, LA 70452-5038
(985) 863-2591
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
009506945
LA
101YP2500X
Professional Counselor
Primary
6538
LA
Other
Enumeration date
11/10/2015
Last updated
09/09/2020
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