Individual
BEVERLY C JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
116 S EDWARD AVENUE, MOUND BAYOU, MS 38762
(662) 719-2005
Mailing address
114 EDWARD AVENUE, SUITE B, MOUND BAYOU, MS 38762
(662) 719-2005
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
MS68NHC
MS
Other
Enumeration date
07/19/2013
Last updated
07/19/2013
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