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1275738692
KENNETH JOHNSON
TAHLEQUAH, OK
NPI
1275738692
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OK 2920)
Enumeration Date
2007-06-16
Last Update Date
2007-07-08
Business Address
-- KENNETH JOHNSON
1400 HENSLEY DR
TAHLEQUAH, OK 74464-5221
Phone number: 918-207-3000
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Mailing Address
-- KENNETH JOHNSON
PO BOX 558
TAHLEQUAH, OK 74465-0558
Phone number: 918-207-3000
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