Individual
KIMBERLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPY
Contact information
Practice address
8870 YOUREE DR STE 108, SHREVEPORT, LA 71115-2512
(318) 344-8021
Mailing address
8870 YOUREE DR STE 108, SHREVEPORT, LA 71115-2512
(318) 344-8021
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
11/10/2018
Last updated
07/24/2019
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