Individual
FELISA JOHNSON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2743 MALCOLM ST, SHREVEPORT, LA 71108-2721
(318) 453-6601
Mailing address
2743 MALCOLM ST, SHREVEPORT, LA 71108-2721
(318) 453-6601
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
Z20178
LA
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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