Individual
MS. JOLISSA JOHNSON BALONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 W 2ND ST, THIBODAUX, LA 70301
(985) 446-5244
(985) 446-5478
Mailing address
102 W 2ND ST, THIBODAUX, LA 70301-3004
(985) 446-5244
(985) 446-5478
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6609
LA
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
009318389
LA
Other
Enumeration date
01/23/2015
Last updated
05/08/2020
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