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Individual

PEGGY M JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC-C

Contact information

Practice address
4122 W 55TH PL STE 119, TULSA, OK 74107-9108
(918) 791-0026
(918) 791-0043
Mailing address
PO BOX 702504, TULSA, OK 74170-2504
(918) 791-0026
(918) 791-0043

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
OK
Enumeration date
01/30/2012
Last updated
03/05/2015
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