Individual
LACHARRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2715 MACKEY PL STE 230, SHREVEPORT, LA 71118-2544
(318) 779-1397
(318) 625-0586
Mailing address
8450 PARKDALE DR, SHREVEPORT, LA 71108-5322
(318) 751-3631
(318) 625-0586
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-154825
—
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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