| Matthew R. Johnson Iii | |
|
620 Oak Harbor Blvd 101 Slidell LA 70458-8862 | |
| (985) 643-2411 | |
| Not Available |
| Full Name | Matthew R. Johnson Iii |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 620 Oak Harbor Blvd, Slidell, Louisiana |
| Authorized Official Name and Position | Matthew R. Johnson (OWNER) |
| Authorized Official Contact | 9856432411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew R. Johnson Iii 620 Oak Harbor Blvd 101 Slidell LA 70458-8862 Ph: (985) 643-2411 | Matthew R. Johnson Iii 620 Oak Harbor Blvd 101 Slidell LA 70458-8862 Ph: (985) 643-2411 |
| NPI Number | 1225589286 |
|---|---|
| Provider Enumeration Date | 10/14/2016 |
| Last Update Date | 10/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225589286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5531 (Louisiana) | Primary |
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