Individual
LISA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16022 WESTWARD HO ST, STAGECOACH, TX 77355-3394
(281) 380-2639
Mailing address
16022 WESTWARD HO ST, STAGECOACH, TX 77355-3394
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210821
TX
Other
Enumeration date
06/11/2012
Last updated
06/11/2012
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