Individual
CELESE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5100 S DORCHESTER AVE, CHICAGO, IL 60615-4118
(773) 966-5039
(872) 813-4175
Mailing address
4807 VICTORIA CHASE CT, JACKSONVILLE, FL 32257-5206
(732) 618-3048
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
056.013821
IL
Other
Enumeration date
02/17/2017
Last updated
11/02/2020
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