Individual
SIMONE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
611 W ADMIRAL DOYLE DR, NEW IBERIA, LA 70560-6408
(337) 373-0002
(337) 373-0129
Mailing address
PO BOX 1254, BROUSSARD, LA 70518-1254
(337) 837-9837
(337) 837-3616
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1166
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1166
SOCIAL WORKER
LA
Enumeration date
02/10/2006
Last updated
11/19/2010
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