Individual
MRS. JESSICA LYNNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR,L
Contact information
Practice address
12430 TESSON FERRY RD, SUITE 352, SAINT LOUIS, MO 63128-2702
(866) 495-5437
Mailing address
1414 DE PORRES LN, SAINT CHARLES, MO 63304-6714
(314) 393-0506
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2006030617
MO
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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