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Individual

PETA-GAYE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
2113 SW 87TH TER, MIRAMAR, FL 33025-2014
(954) 430-9913
(305) 826-1545
Mailing address
2113 SW 87TH TER, MIRAMAR, FL 33025-2014
(954) 430-9913
(305) 826-1545

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12315
FL

Other

Enumeration date
01/02/2014
Last updated
01/02/2014
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