Individual
JOHANNA LEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 W QUESENBURY AVE, SALLISAW, OK 74955-3613
(918) 790-2653
(918) 790-2657
Mailing address
PO BOX 179, STIGLER, OK 74462-0179
(918) 967-4650
(918) 967-4582
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/28/2010
Last updated
07/30/2010
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