Individual
SHANNON GAIL ROYE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
904 NW 4TH ST, STIGLER, OK 74462-1653
(918) 686-3790
Mailing address
904 NW 4TH ST, STIGLER, OK 74462-1653
(918) 686-3790
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4341
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200356420A
—
OK
Enumeration date
09/20/2010
Last updated
03/17/2020
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