Individual
ERVINA MAE JOHNSON-MAYTUBBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8828 OAKRIDGE DR, MIDWEST CITY, OK 73110-7418
(214) 854-8516
Mailing address
8828 OAKRIDGE DR, MIDWEST CITY, OK 73110-7418
(214) 854-8516
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/10/2011
Last updated
07/14/2016
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