Individual
JENNIFER NICOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMII
Contact information
Practice address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 214-5101
(405) 878-5846
Mailing address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 214-5101
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPCCANDIDATE12949
OK
171M00000X
Case Manager/Care Coordinator
Primary
313526
OK
Other
Enumeration date
03/20/2007
Last updated
09/30/2025
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