Individual
MELISSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 PARC HILL BLVD, ORANGE CITY, FL 32763-8029
(386) 960-8277
(857) 290-9134
Mailing address
4580 ALDER DR, PORT ORANGE, FL 32127-9255
(386) 451-7957
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10749
FL
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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