Individual
MRS. MARY ANN CROSETTO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2653 COUNTY ROAD 74, SAINT CLOUD, MN 56301-2205
(320) 229-4069
Mailing address
12840 62ND ST NE, SPICER, MN 56288-9334
(320) 444-8986
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
119642
TX
225X00000X
Occupational Therapist
17-03488
KS
225XP0200X
Pediatric Occupational Therapist
Primary
106785
MN
Other
Enumeration date
02/15/2019
Last updated
12/12/2022
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