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Individual

MISS AMY MARIE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
4700 W. 13TH ST. N, WICHITA, KS 67212
(316) 943-3092
Mailing address
7733 FORSYTH BOULEVARD, SUITE 2300, ST. LOUIS, MO 63105
(800) 677-1238

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00691
KS

Other

Enumeration date
09/30/2010
Last updated
09/30/2010
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