Individual
JESSICA WHITEHERSE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
310 CORPORATE DR SUIT 101, KNOXVILLE, TN 37923-3792
(865) 769-0801
Mailing address
432 GAUT RD, DANDRIDGE, TN 37725-3202
(386) 253-3751
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA0000002329
TN
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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