Individual
IISHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
4209 NW 23RD ST, SUITE 100, OKLAHOMA CITY, OK 73107-2645
(405) 917-1709
(405) 917-1713
Mailing address
4209 NW 23RD ST, SUITE 100, OKLAHOMA CITY, OK 73107-2645
(405) 917-1709
(405) 917-1713
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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