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NPI Profile for TRACY L JOHNSON in SHREVEPORT, LA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pastoral |
101YP1600X |
| NPI Number | 1962859132 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/18/2016 | |
| Last updated | 05/18/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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TRACY L JOHNSON
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TRACY L JOHNSON