Doctor Name: | JESSICA FRANKS JOHNSON |
NPI Number: | 1073919767 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 4417 |
Business Practice Address: | 328 N Main St Breaux Bridge, LA - 705174923 |
Business Phone Number: | 3373322844 |
Business Fax Number: | 3373325458 |
Mailing Address: | 1328h Johnson Rd, BREAUX BRIDGE |
State: | LA |
Postal Code: | 705177014 |
Phone Number: | 3378493736 |
Fax Number: | |
NPI Enumeration Date: | 11/07/2014 |
NPI Last Update Date: | 11/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4417 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |