Individual
JACQUELINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3621 N KELLEY AVE STE 100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
916 NE 21ST ST, OKLAHOMA CITY, OK 73105-8216
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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