Individual
JOHNESSA WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 MARSHALL ST, SHREVEPORT, LA 71101-4139
(318) 226-9944
Mailing address
1717 MARSHALL ST, SHREVEPORT, LA 71101-4139
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/17/2016
Last updated
12/19/2018
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