Individual
KAMIQUE MICHELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHP, PHD
Contact information
Practice address
609 REDWATER RD., WAKE VILLAGE, TX 75501-7550
(903) 501-8032
(903) 582-7338
Mailing address
2927 KING OAKS LOOP, SHREVEPORT, LA 71107-4224
(318) 780-2828
(866) 343-8862
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/30/2018
Last updated
01/03/2022
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