Individual
DR. LAQUITA L. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
102 WILLIAMS STREET, HAZLEHURST, MS 39083
(601) 622-6165
Mailing address
102 WILLIAMS STREET, HAZLEHURST, MS 39083
(601) 622-6165
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
0202216144
VA
1835P2201X
Ambulatory Care Pharmacist
Primary
0202216144
VA
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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