Individual
MORGAN DIETERICH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2285 BENTON RD STE C200, BOSSIER CITY, LA 71111-3554
(318) 741-5909
Mailing address
2285 BENTON RD STE C200, BOSSIER CITY, LA 71111-3554
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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