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Individual
DR. MADELYN ROSE JOHNSON
Active
Individual
DR. MADELYN ROSE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
024790
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024790
THE UNIVERSITY OF THE STATE OF NEW YORK, EDUCATION DEPARTMENT
NY
01
—
438539
NATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY
—
Enumeration date
07/30/2020
Last updated
01/12/2021
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