Individual
MRS. LORI JEANNE TUCKER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6105 NW 45TH TER, COCONUT CREEK, FL 33073-1954
(954) 240-5568
Mailing address
6105 NW 45TH TER, COCONUT CREEK, FL 33073-1954
(954) 240-5568
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10779
FL
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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