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1225325301
QUINTRELL DESHAUN JOHNSON
OKLAHOMA CITY, OK
NPI
1225325301
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-07-08
Last Update Date
2011-07-08
Business Address
Mr. QUINTRELL DESHAUN JOHNSON
3621 N KELLEY AVE SUITE 100
OKLAHOMA CITY, OK 73111-4520
Phone number: 405-524-5525
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Mailing Address
Mr. QUINTRELL DESHAUN JOHNSON
3213 NW 43RD ST
OKLAHOMA CITY, OK 73112-6247
Phone number: 405-639-7979
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