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Individual

MRS. WILLETTA DORIS JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
5790 DENLINGER RD, DAYTON, OH 45426-1838
(937) 837-5581
Mailing address
1205 WESTBROOK RD, DAYTON, OH 45415-1902
(937) 854-2117

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTA 00282
OH

Other

Enumeration date
01/08/2009
Last updated
01/08/2009
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