Individual
CARLA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6440 S LEWIS AVE STE 2200, TULSA, OK 74136-1060
(918) 712-0859
Mailing address
1601 OLD SOUTH RIVER RD, SAINT CHARLES, MO 63303-4120
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7583
OK
101YS0200X
School Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746170G
—
OK
Enumeration date
12/29/2014
Last updated
04/22/2024
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