Individual
AILEEN JOHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS;OTR/L
Contact information
Practice address
5121 COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-7572
Mailing address
13021 S 3040 W, RIVERTON, UT 84065-6898
(801) 253-4543
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2855644201
UT
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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