Individual
MS. MIESHA RAYNETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
825 STIVER DR, OKLAHOMA CITY, OK 73110-2568
(405) 455-7142
Mailing address
825 STIVER DR, OKLAHOMA CITY, OK 73110-2568
(405) 455-7142
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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