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Byron Lee Johnson, PRSS
Peer Specialist in Ada, Oklahoma
NPI 1629718887

Byron Lee Johnson is a Peer Specialist based in Ada, OK. Byron Lee Johnson practices in Ada, OK and has the professional credentials of PRSS. The NPI Number for Byron Lee Johnson is 1629718887 and holds a License No. (Oklahoma).

The current practice location address for Byron Lee Johnson is 3115 Arlington St, Ada, OK and can be reached out via phone at 580-332-6345 and via fax at 580-421-7724. You can also correspond with Byron Lee Johnson through the mailing address at 3115 ARLINGTON ST, ADA, OK - 74820-3085 (mailing address contact number: 580-332-6345).

Location: 3115 Arlington St, Ada, OK, 74820-3085
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629718887
Provider Name
Byron Lee Johnson
Credential
PRSS
Provider Entity Type
Individual
Gender
Male
Address
3115 Arlington St, Ada, OK, 74820-3085
Phone Number
580-332-6345
Fax Number
580-421-7724
Provider Enumeration Date
03/29/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3115 Arlington St
City
Ada
State
Oklahoma
Zip
74820-3085
Phone Number
580-332-6345
Fax Number
580-421-7724
person
Provider Business Mailing Address Details
Address
3115 Arlington St
City
Ada
State
Oklahoma
Zip
74820-3085
Phone Number
580-332-6345
Fax Number
580-421-7724
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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