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Individual

DR. JOHNNY R THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
114 N OAK ST, PONCA CITY, OK 74601-4238
(580) 491-9625
(580) 762-8700
Mailing address
114 NORTH OAK ST, PONCA CITY, OK 74601
(580) 491-9625
(580) 762-8700

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
101YS0200X
School Counselor
103K00000X
Behavior Analyst
104100000X
Social Worker
106H00000X
Marriage & Family Therapist

Other

Enumeration date
07/26/2013
Last updated
07/26/2013
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