Individual
MISS ANGEL BREAIL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
2520 NW 39TH TER, SUITE100, OKLAHOMA CITY, OK 73112-3730
(405) 413-2077
Mailing address
7272 E 37TH ST N APT 701, WICHITA, KS 67226-3215
(405) 875-2174
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
M0823645
OK
Other
Enumeration date
02/26/2013
Last updated
08/22/2024
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