Individual
BLAKE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2012 S JONES BLVD, LAS VEGAS, NV 89146-3151
(702) 360-1137
Mailing address
985 WIGWAM PKWY UNIT 4206, HENDERSON, NV 89014-6837
(407) 242-5344
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/05/2018
Last updated
08/05/2018
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