Individual
JESSICA LAUREN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1315 W ADDISON ST, APT. 1A, CHICAGO, IL 60613-3738
(815) 252-8773
Mailing address
1315 W ADDISON ST, APT. 1A, CHICAGO, IL 60613-3738
(815) 252-8773
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008470
IL
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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