Individual
LORI SUE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3150 N WINDING BROOK RD, FLAGSTAFF, AZ 86001-0972
(928) 774-7106
Mailing address
1718 N FORT VALLEY RD, APT. 126, FLAGSTAFF, AZ 86001-1290
(928) 380-0289
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2514
AZ
Other
Enumeration date
12/24/2007
Last updated
12/24/2007
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