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Individual

TIFFANY RANELLE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3341 YOUREE DR STE 10B, SHREVEPORT, LA 71105-2149
(318) 675-0804
Mailing address
9418 E MONTEGO LN, SHREVEPORT, LA 71118-3608
(318) 663-4493

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
13482
LA

Other

Enumeration date
10/13/2016
Last updated
01/24/2025
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