Individual
HEIDI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 N 6TH ST, CLINTON, OK 73601-2422
(866) 926-6552
Mailing address
500 N 6TH ST, CLINTON, OK 73601-2422
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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