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Individual

JENNIFER CLARK JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
408 NE HAWTHORNE AVE, BEND, OR 97701-4729
(541) 604-0548
Mailing address
855 NW HALEAKALA WAY, BEND, OR 97701-6726
(541) 604-0548

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1002972
OR

Other

Enumeration date
02/18/2013
Last updated
02/18/2013
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