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Gabriel Blake Johnson
Peer Specialist in Tahlequah, Oklahoma
NPI 1962271155

Gabriel Blake Johnson is a Peer Specialist based in Tahlequah, OK. Gabriel Blake Johnson practices in Tahlequah, OK. The NPI Number for Gabriel Blake Johnson is 1962271155 and holds a License No. (Oklahoma).

The current practice location address for Gabriel Blake Johnson is 214 N Bliss Ave, Tahlequah, OK and can be reached out via phone at 539-234-3785.

Location: 214 N Bliss Ave, Tahlequah, OK, 74464-2520
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962271155
Provider Name
Gabriel Blake Johnson
Credential
Provider Entity Type
Individual
Gender
Male
Address
214 N Bliss Ave, Tahlequah, OK, 74464-2520
Phone Number
539-234-3785
Fax Number
Provider Enumeration Date
12/28/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
214 N Bliss Ave
City
Tahlequah
State
Oklahoma
Zip
74464-2520
Phone Number
539-234-3785
Fax Number
person
Provider Business Mailing Address Details
Address
214 N Bliss Ave
City
Tahlequah
State
Oklahoma
Zip
74464-2520
Phone Number
539-234-3785
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Oklahoma)
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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