Individual
TRACI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8811 FAIRFIELD GREENS DR, MIDWEST CITY, OK 73110-8015
(405) 887-0217
Mailing address
8811 FAIRFIELD GREENS DR, MIDWEST CITY, OK 73110-8015
(405) 887-0217
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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