Individual
KELLI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1575 HOOVER DR, NORTH MANKATO, MN 56003-2667
(507) 387-2037
Mailing address
16 SNOWBIRD CT, NORTH MANKATO, MN 56003-1637
(507) 317-1814
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105404
MN
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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