Individual
HEIDI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2418 E FAIRFIELD ST, MESA, AZ 85213-5303
(602) 319-7324
Mailing address
2418 E. FAIRFIELD, MESA, AZ 85213
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6215
AZ
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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