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Individual

KELLY SHAVONNE JOHNSON-MEANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
715 N SAWYER AVE, CHICAGO, IL 60624-1532
(773) 742-6581
Mailing address
715 N SAWYER AVE, CHICAGO, IL 60624-1532
(773) 742-6581

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013862
IL

Other

Enumeration date
10/28/2020
Last updated
10/28/2020
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