Individual
MATTEA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3120 25TH ST S STE N, FARGO, ND 58103-6110
(701) 205-4194
Mailing address
3120 25TH ST S STE N, FARGO, ND 58103-6110
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2225
ND
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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