Provider Demographics
NPI:1477689057
Name:JOHNSON-PRINCE, SABRINA RAYE (MHR, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:RAYE
Last Name:JOHNSON-PRINCE
Suffix:
Gender:F
Credentials:MHR, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BURRIS DR
Mailing Address - Street 2:
Mailing Address - City:YALE
Mailing Address - State:OK
Mailing Address - Zip Code:74085-4005
Mailing Address - Country:US
Mailing Address - Phone:405-880-5426
Mailing Address - Fax:405-377-0269
Practice Address - Street 1:720 S HUSBAND ST
Practice Address - Street 2:SUITE 15
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4660
Practice Address - Country:US
Practice Address - Phone:405-377-6768
Practice Address - Fax:405-377-0269
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK884106H00000X
LA312106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist