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Individual

KENNARIUS JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MHS

Contact information

Practice address
9663 HERON SPRINGS DR, SHREVEPORT, LA 71106-1662
(318) 573-2676
Mailing address
9663 HERON SPRINGS DR, SHREVEPORT, LA 71106-1662

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
10/20/2016
Last updated
10/20/2016
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