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General NPI Number Information
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NPI Number | 1275163198
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Entity Type | Individual
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Provider Name | JASMINE HARRIS-JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 01/20/2020
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 1585 3RD ST
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City | FORT JOHNSON
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State | LA
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Zip | 71459-5102
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Country | US
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Telephone | 337-531-2795
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Fax |
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Provider Business Mailing Address
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Address Line | 3625 YOUREE DR
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City | SHREVEPORT
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State | LA
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Zip | 71105-2121
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 12647
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License Number State | LA
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