Provider Demographics
NPI:1326449133
Name:JOHNSON, GAIL
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:INAZ
Other - Last Name:MURCHISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8136 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-4817
Mailing Address - Country:US
Mailing Address - Phone:405-203-9103
Mailing Address - Fax:
Practice Address - Street 1:3500 SW 119TH ST
Practice Address - Street 2:MID-AMERICA CHRISTIAN UNIVERSITY
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-4500
Practice Address - Country:US
Practice Address - Phone:405-203-9103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst