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Individual

DR. GWENDOLYN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
9212 N KELLEY AVE STE 200, OKLAHOMA CITY, OK 73131-2419
(405) 242-5070
(405) 242-5071
Mailing address
3375 BILLY PL, EDMOND, OK 73034-9318
(405) 517-6369

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5801
OK
251S00000X
Community/Behavioral Health Agency
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
BGJ2011
OK
Enumeration date
11/23/2011
Last updated
09/04/2025
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