Individual
MARC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
1212 S AIR DEPOT BLVD STE 17, MIDWEST CITY, OK 73110-4860
(405) 455-6868
(800) 856-0132
Mailing address
1212 S AIR DEPOT BLVD STE 17, MIDWEST CITY, OK 73110-4860
(405) 455-6868
(800) 856-0132
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-143596
OK
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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