Individual
MS. KATRINA DENEAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
1901 WHIPPORWILL LN, KILGORE, TX 75662-3880
(903) 984-6264
Mailing address
1517 EDNA LN, LONGVIEW, TX 75602-4915
(903) 557-0746
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209900
TX
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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