Individual
MRS. JOHNNA NKWONTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7132 NW 21ST ST, BETHANY, OK 73008-5715
(405) 816-7775
Mailing address
7132 NW 21ST ST, BETHANY, OK 73008-5715
(405) 816-7775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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