Individual
MIA D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 N LOTTIE AVE, OKLAHOMA CITY, OK 73117-2051
(509) 230-1542
Mailing address
2525 W GLENHAVEN DR APT 262, MIDWEST CITY, OK 73110-4477
(323) 571-9458
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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