Individual
MRS. KIMBERLY SUZANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5040 E SHEA BLVD, SUITE 168, SCOTTSDALE, AZ 85254-4600
(480) 483-1025
(480) 483-1026
Mailing address
9437 W AVENIDA DEL SOL, PEORIA, AZ 85383-1135
(623) 215-8444
(480) 483-1026
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2534
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
503129
—
AZ
Enumeration date
01/03/2007
Last updated
09/09/2011
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