Individual
CONNIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5373 THOMPSONS MILL RD., BRASELTON, GA 30517
(770) 965-7003
Mailing address
898 CAPITOL VIEW AVE NW, ATLANTA, GA 30318-8331
(678) 914-4640
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001766
GA
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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