Individual
KACEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2911 LONGVIEW DR, JONESBORO, AR 72401-5911
(870) 336-0238
Mailing address
329 COUNTY ROAD 485, RECTOR, AR 72461-8709
(870) 783-0666
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A2002
AR
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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