Organization
VICTORY GRACE HEALING MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANNEL JOHNSON PMHNP (OWNER)
(918) 428-8713
Entity
Organization
Contact information
Practice address
3171 S 129TH EAST AVE # A2076, TULSA, OK 74134-3205
(918) 428-8713
Mailing address
3171 S 129TH EAST AVE # A2076, TULSA, OK 74134-3205
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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