Individual
AMY MELISSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3821 WILSON BLVD, ARLINGTON, VA 22203-1981
(423) 405-3075
Mailing address
1223 BURDETTE RD, GRANDVIEW, TN 37337-5607
(865) 548-1515
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002856
VA
224Z00000X
Occupational Therapy Assistant
3660
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA0000003660
OCCUPATIONAL THERAPY ASSISTANT LICENSE
TN
Enumeration date
01/20/2022
Last updated
08/07/2023
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