Individual
MRS. JANCY DIANA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
542 W STROTHERS AVE, SEMINOLE, OK 74868-3175
(405) 255-2835
Mailing address
542 W STROTHERS AVE, SEMINOLE, OK 74868-3175
(405) 255-2835
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
T005257690
OK
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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