Individual
MS. LYNETTE JACQUELINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S., MAMFT
Contact information
Practice address
15400 LAKESHORE DR, PIEDMONT, OK 73078-9014
(405) 373-4254
Mailing address
15400 LAKE SHORE DRIVE, PIEDMONT, OK 73078-7307
(405) 373-4254
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC ELIGIBLE
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
OK
Enumeration date
01/02/2009
Last updated
01/02/2009
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