Individual
DESHA RENEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
401 E BROADWAY CT STE E, SAND SPRINGS, OK 74063-7931
(918) 245-5565
Mailing address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 565-4093
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/15/2017
Last updated
01/24/2025
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