Individual
SHAVESHA LALETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS
Contact information
Practice address
1717 MARSHALL ST, SHREVEPORT, LA 71101-4139
(318) 226-9942
(318) 226-9944
Mailing address
400 JOHN WESLEY BLVD, APT 38, BOSSIER CITY, LA 71112-2299
(318) 560-3093
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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