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1962271155
GABRIEL BLAKE JOHNSON
TAHLEQUAH, OK
NPI
1962271155
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-12-28
Last Update Date
2023-12-28
Business Address
GABRIEL BLAKE JOHNSON
214 N BLISS AVE
TAHLEQUAH, OK 74464-2520
Phone number: 539-234-3785
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Mailing Address
GABRIEL BLAKE JOHNSON
214 N BLISS AVE
TAHLEQUAH, OK 74464-2520
Phone number: 539-234-3785
Copy
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