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Individual

MS. JANE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
2201 N BEDELL AVE, #B, DEL RIO, TX 78840-8007
(830) 774-1556
(830) 774-6150
Mailing address
2201 N BEDELL AVE, #B, DEL RIO, TX 78840-8007
(830) 774-1556
(830) 774-6150

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT110488
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8T4300
BLUE CROSS ID NUMBER
TX
Enumeration date
06/08/2006
Last updated
02/04/2008
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