Individual
LAREISHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2436 N NOTTINGHAM WAY APT 79, MOORE, OK 73160-1252
(405) 889-8702
Mailing address
2436 N NOTTINGHAM WAY APT 79, MOORE, OK 73160-1252
(405) 889-8702
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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