Individual
LYDIA CHARLYN JOHSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6685 SULLIVAN RD STE B, GREENWELL SPRINGS, LA 70739-3112
(225) 261-7143
(225) 250-1026
Mailing address
6685 SULLIVAN RD STE B, GREENWELL SPRINGS, LA 70739-3112
(225) 261-7143
(225) 250-1026
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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