Individual
MRS. NICOLE ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
415 BAILEY DR, COLUMBIA, MO 65203-6841
(573) 303-7252
Mailing address
7715 E CEDAR HILLS RD, ASHLAND, MO 65010-9362
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2007023064
MO
Other
Enumeration date
02/09/2020
Last updated
02/09/2020
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