Individual
TAYLOR T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6496
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100135268
—
WI
Enumeration date
11/09/2020
Last updated
11/09/2023
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