Individual
DR. CHAD VERNON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1927 S BOSTON AVE, #204, TULSA, OK 74119-5259
(918) 406-6763
Mailing address
4502 E 41ST ST, SCHUSTERMAN CENTER, TULSA, OK 74135-9923
(918) 406-6763
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1070
OK
103TH0100X
Health Service Psychologist
1070
OK
103TP2701X
Group Psychotherapy Psychologist
1070
OK
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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