Individual
OKEYA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 ELIZABETH ST, JACKSONVILLE, FL 32206-4138
(910) 574-2031
Mailing address
1605 ELIZABETH ST, JACKSONVILLE, FL 32206-4138
(910) 574-2031
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222Q00000X
FAMILY MATTERS
—
Enumeration date
03/11/2020
Last updated
01/25/2023
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