Individual
MRS. ANTIONETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7232 GERMAN HILL RD, DUNDALK, MD 21222-1260
(410) 282-6310
Mailing address
1514 MANDEVILLE LANE, JOPPA, MD 21085
(443) 540-8660
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
AO2305
MD
Other
Enumeration date
06/19/2017
Last updated
07/21/2022
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