Provider Demographics
NPI:1538814199
Name:JOHNS, DONICA L
Entity type:Individual
Prefix:
First Name:DONICA
Middle Name:L
Last Name:JOHNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 LOUIS PRIMA DR E
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2809
Mailing Address - Country:US
Mailing Address - Phone:504-256-5753
Mailing Address - Fax:
Practice Address - Street 1:1042 ANNUNCIATION ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3831
Practice Address - Country:US
Practice Address - Phone:504-303-4646
Practice Address - Fax:504-910-9773
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health