Individual
JOHNNIE LYNNETTE WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,LPC,MHP
Contact information
Practice address
RR 2 BOX 497, VALLIANT, OK 74764-9793
(580) 743-6214
Mailing address
RR 2 BOX 497, VALLIANT, OK 74764-9793
(580) 743-6214
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3332
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101Y00000X
—
OK
Enumeration date
01/24/2007
Last updated
07/21/2011
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