Individual
WINONA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5131 N CLASSEN BLVD, OKLAHOMA CITY, OK 73118-5258
(405) 767-1126
Mailing address
PO BOX 92, MERIDIAN, OK 73058-0092
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J082520017
—
OK
Enumeration date
08/26/2009
Last updated
08/26/2009
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