Individual
DIANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 JEFFERSON DAVIS BLVD, NATCHEZ, MS 39120-5104
(601) 653-4581
Mailing address
220 COUNTRY CLUB DR, NATCHEZ, MS 39120-8802
(769) 285-4579
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
PH4296
MS
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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