Individual
PASSION JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 E MEMORIAL RD STE C1, OKLAHOMA CITY, OK 73114-2218
(405) 577-1411
(844) 447-0582
Mailing address
1707 PROFESSIONAL CIR, YUKON, OK 73099-6470
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-289951
OK
Other
Enumeration date
10/19/2023
Last updated
01/17/2024
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