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Organization
INTRINSIC HEALTH
Active
Organization
INTRINSIC HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACHARY RAE JOHNSON LCSW (PSYCHOTHERAPIST)
(918) 688-5526
Entity
Organization
Contact information
Practice address
5100 N BROOKLINE AVE STE 630, OKLAHOMA CITY, OK 73112-3623
(918) 688-5526
Mailing address
5100 N BROOKLINE AVE STE 630, OKLAHOMA CITY, OK 73112-3623
(918) 688-5526
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295280642
TYPE 1 NPI
—
01
—
6632
LCSW
OK
Enumeration date
05/21/2019
Last updated
05/21/2019
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