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Individual

MR. DEVIN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4845 JAMESTOWN AVE STE 208, BATON ROUGE, LA 70808-3248
(225) 757-6615
Mailing address
10335 LEBANON ST, BATON ROUGE, LA 70816-8170
(225) 354-5356

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011015603
LA
Enumeration date
02/20/2019
Last updated
02/20/2019
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