GABRIEL BLAKE JOHNSON

TAHLEQUAH, OK
NPI1962271155
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2023-12-28
Last Update Date2023-12-28
Business Address
GABRIEL BLAKE JOHNSON
214 N BLISS AVE
TAHLEQUAH, OK 74464-2520
Phone number: 539-234-3785
Mailing Address
GABRIEL BLAKE JOHNSON
214 N BLISS AVE
TAHLEQUAH, OK 74464-2520
Phone number: 539-234-3785