Individual
MS. SHANNON CHAUNTAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
200 MERIDIAN WAY, RICHMOND, KY 40475-3331
(859) 353-6777
Mailing address
279 S EAGLE CREEK DR, LEXINGTON, KY 40515-5919
(859) 948-2305
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
175326
KY
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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