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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, February 20, 2024 4:03 PM CST
Next Update: Wednesday, February 21, 2024 2:50 AM CST

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JOHNSON, TINA DIANE
Practice Address: ROBERT M. GREER CENTER/LIBERTY HEALTHCARE
2501 DELAWARE
ENID OK 73701

Address last updated on 11/1/2023
Phone #: (580) 213-2700
Fax #:
County: OKLAHOMA
License: 229
Dated: 8/27/2020
Expires: 11/30/2025
Temp. Ltr. Issued: 7/2/2020
Temp. Ltr. Expires: 9/10/2020
License Type: Therapeutic Recreation Specialist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 0
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
ROBERT M. GREER CENTER/LIBERTY HEALTHCARE
2501 DELAWARE
ENID OK 73701

Phone #: (580) 213-2700
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JULIE KAY COSTILLA TRS 61

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