Individual
MARTINEZ JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS
Contact information
Practice address
2715 MACKEY PL STE 119, SHREVEPORT, LA 71118-2527
(318) 771-7707
(318) 383-6685
Mailing address
P.O. BOX 56, COTTON VALLEY, LA 71018
(318) 205-2839
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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