Individual
DEMETRIC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5221 EDENBORO RD, NEW ORLEANS, LA 70127-3010
(504) 236-2418
Mailing address
5221 EDENBORO RD, NEW ORLEANS, LA 70127-3010
(504) 236-2418
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
171W00000X
Contractor
—
—
Other
Enumeration date
01/09/2017
Last updated
05/07/2021
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