Individual
ESSENCE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5131 N CLASSEN BLVD, OKLAHOMA CITY, OK 73118-5258
(405) 767-1126
Mailing address
4825 NE 48TH ST, OKLAHOMA CITY, OK 73121-6233
(405) 593-3008
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H081249623
—
OK
Enumeration date
11/15/2011
Last updated
11/15/2011
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