Organization
OVERTON BROOKS VAMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRUSHUNDA MONIQUE JOHNSON M.S.W. (CLINICAL SOCIAL WORKER)
(318) 990-5387
Entity
Organization
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-5387
Mailing address
535 ANTIETAM DR, BOSSIER CITY, LA 71112-4789
(318) 990-5387
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
8840
LA
Other
Enumeration date
02/11/2009
Last updated
02/11/2009
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