Individual
SAMANTHA GRACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7306 S YALE AVE, TULSA, OK 74136-7027
(918) 280-0090
Mailing address
PO BOX 33568, SAN DIEGO, CA 92163-3568
(855) 223-7123
(619) 374-7134
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-77420
OK
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/17/2021
Last updated
01/20/2025
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