Individual
MACKENZIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 N ROYAL ST, DERIDDER, LA 70634-3851
(337) 202-8803
(337) 222-4013
Mailing address
PO BOX 642, DRY CREEK, LA 70637-0642
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
LA
Other
Enumeration date
01/02/2026
Last updated
01/02/2026
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