Individual
MS. ANNJAVETTA D. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
2000 E LINCOLN RD, IDABEL, OK 74745-7353
(580) 286-6639
Mailing address
2000 E LINCOLN RD, IDABEL, OK 74745-7353
(580) 286-6639
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538480157
—
OK
Enumeration date
06/17/2010
Last updated
06/03/2019
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