Individual
MR. JIM D. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1911 NW 72ND ST, LAWTON, OK 73505-2609
(580) 536-1900
Mailing address
1911 NW 72ND ST, LAWTON, OK 73505-2609
(580) 536-1900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
36
OK
Other
Enumeration date
10/04/2006
Last updated
12/31/2010
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