Individual
HEATHER RENE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 LAKESIDE DR NE, GRAND RAPIDS, MI 49503-3811
(616) 588-1680
Mailing address
7025 REFLECTION DR NE, COMSTOCK PARK, MI 49321-9639
(231) 250-3778
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007133
MI
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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