Individual
DIRENE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
396 NORTH MAIN STREET, SIBLEY, LA 71073
(318) 947-9084
Mailing address
PO BOX 134, SIBLEY, LA 71073-0134
(346) 857-9164
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9035
LA
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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