Individual
MISS JESSICA KAY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
230 E 12TH ST, ADA, OK 74820-6508
(580) 332-3001
Mailing address
230 E 12TH ST, ADA, OK 74820-6508
(580) 332-3001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
6265
OK
Other
Enumeration date
05/07/2012
Last updated
10/03/2023
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