Individual
EVELYN GIBSON-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5930 E 31ST ST, TULSA, OK 74135-5107
(918) 270-2413
Mailing address
10800 E 123RD ST N, COLLINSVILLE, OK 74021-5427
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000000
—
OK
Enumeration date
01/18/2016
Last updated
01/18/2016
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