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Individual

JACINTH JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5977 HEIDEL AVE, BATON ROUGE, LA 70805-5320
(999) 999-9999
Mailing address
5977 HEIDEL AVE, BATON ROUGE, LA 70805-5320
(999) 999-9999

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
106S00000X
Behavior Technician
Primary
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
01/22/2018
Last updated
02/22/2022
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