Individual
MR. CEDRICK JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1311 N LOTTIE AVE, OKLAHOMA CITY, OK 73117-2051
(405) 600-3074
(405) 605-8120
Mailing address
812 NW 143RD ST, EDMOND, OK 73013-1926
(405) 820-2072
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
10/17/2024
Last updated
01/06/2026
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