Individual
CRYSTAL LEIGHANN JOHNSON
Active
Individual
CRYSTAL LEIGHANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3643
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12115
VA
—
01
—
33297
TLC
TN
05
—
3729568
—
TN
01
—
4158884
BLUE CROSS
TN
01
—
P00103288
PALMETTO GBA RR MEDICARE
TN
Enumeration date
08/31/2006
Last updated
09/19/2008
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