Individual
TANEKA RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2808 NW 31ST ST, OKLAHOMA CITY, OK 73112-7407
(405) 885-5962
Mailing address
124 BRADFORD PL, MIDWEST CITY, OK 73130-3541
(405) 869-7158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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