Individual
TIAYANIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(405) 424-7711
Mailing address
1812 NE 51ST ST, OKLAHOMA CITY, OK 73111-7006
(405) 410-1285
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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