Provider Demographics
NPI:1437316031
Name:JOHNSON, DEANN MORRIS (PHD)
Entity Type:Individual
Prefix:
First Name:DEANN
Middle Name:MORRIS
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10211 SIEGEN LANE
Mailing Address - Street 2:STE 2B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810
Mailing Address - Country:US
Mailing Address - Phone:225-767-3121
Mailing Address - Fax:
Practice Address - Street 1:10211 SIEGEN LANE
Practice Address - Street 2:STE 2B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810
Practice Address - Country:US
Practice Address - Phone:225-767-3121
Practice Address - Fax:225-767-3122
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1043103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical