Individual
PHYLLIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14409 GREENVIEW DR STE 102, LAUREL, MD 20708-4213
(301) 498-8100
Mailing address
PO BOX 500, BROOKEVILLE, MD 20833-0500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01756
MD
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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