Individual
MRS. KIMBERLY A JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
1425 N MAIN ST, HARRISON, AR 72601-2214
(870) 741-4500
(870) 741-4507
Mailing address
405 OXFORD ST, HARRISON, AR 72601-4641
(870) 741-4529
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1376
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W530
BLUE CROSS BLUE SHIELD
AR
Enumeration date
11/02/2005
Last updated
07/08/2007
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