Provider Demographics
NPI:1467272427
Name:JOHNSON, EMMA NOELLE (MS, LMFT-CANDIDATE)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:NOELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, LMFT-CANDIDATE
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:JOHNSON
Other - Last Name:AUSTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMFT-CANDIDATE
Mailing Address - Street 1:905 N DRYDEN CIR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-7111
Mailing Address - Country:US
Mailing Address - Phone:720-277-7593
Mailing Address - Fax:
Practice Address - Street 1:2224 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-5154
Practice Address - Country:US
Practice Address - Phone:405-377-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist