Individual
NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1414 7TH AVENUE, GLENMORA, LA 71433
(318) 748-8145
Mailing address
35 REDMOND LOOP, GLENMORA, LA 71433-4840
(318) 791-6226
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15492
LA
Other
Enumeration date
10/22/2020
Last updated
08/04/2022
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