Individual
ANNEMARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10303 QUAAL RD, BLACK HAWK, SD 57718-9343
(605) 787-5798
Mailing address
10303 QUAAL RD, BLACK HAWK, SD 57718-9343
(605) 787-5798
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0145
SD
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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