Individual
DANELLA DENISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSBA/BSBM
Contact information
Practice address
8422 N 123RD EAST AVE, OWASSO, OK 74055-2130
(918) 858-4353
Mailing address
8422 N 123RD EAST AVE, OWASSO, OK 74055-2130
(918) 858-4353
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
OK
Enumeration date
02/21/2017
Last updated
07/28/2023
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