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Individual

ASHLEE DAWN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2704 N BROADWAY ST, POTEAU, OK 74953-5402
(918) 649-0909
Mailing address
101 SUNSET ST, WILBURTON, OK 74578-3213
(918) 413-3441

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
OK

Other

Enumeration date
08/14/2018
Last updated
08/14/2018
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