Individual
KENEISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1725 N GLEASON AVE, BETHANY, OK 73008-6149
(405) 401-2824
Mailing address
1725 N. GLEASON AVE, BETHANY, OK 73008
(405) 401-2824
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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