Individual
CRAIG L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6655 S YALE AVE, LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL, TULSA, OK 74136-3326
(918) 491-3702
(918) 491-5740
Mailing address
PO BOX 21228, DEPARTMENT 31, TULSA, OK 74121-1228
(918) 491-3702
(918) 491-5740
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
563
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136705
CIGNA BEHAVIORAL HEALTH
—
Enumeration date
02/21/2006
Last updated
03/05/2008
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