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General NPI Number Information
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NPI Number | 1821591389
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Entity Type | Individual
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Provider Name | MRS. RACQUEL JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 1901 WESTBANK EXPY STE 550
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City | HARVEY
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State | LA
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Zip | 70058-4362
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Country | US
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Telephone | 504-259-0274
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Fax |
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Provider Business Mailing Address
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Address Line | 552 DELMAR ST
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City | TERRYTOWN
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State | LA
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Zip | 70056-2860
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Country | US
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Telephone | 504-259-0274
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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 |
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License Number State |
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