Individual
WHITNEY ANNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
107 E ANDERSON AVE, WAURIKA, OK 73573-3008
(918) 906-5370
Mailing address
107 E ANDERSON AVE, WAURIKA, OK 73573-3008
(918) 906-5370
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
114444
TX
225X00000X
Occupational Therapist
Primary
1673
OK
225XP0019X
Physical Rehabilitation Occupational Therapist
1673
OK
225XP0200X
Pediatric Occupational Therapist
1673
OK
Other
Enumeration date
11/14/2011
Last updated
04/03/2017
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