NPI | 1245507946 |
---|---|
Other Name | GWENDOLYN JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: OK 5801) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2011-11-23 |
Last Update Date | 2025-09-04 |