Individual
MRS. ANGIE STALEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
5729 N COUNTRY CLUB BLVD, LITTLE ROCK, AR 72207-4345
(501) 663-3351
Mailing address
5729 N COUNTRY CLUB BLVD, LITTLE ROCK, AR 72207-4345
(501) 663-3351
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1942
AR
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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