Individual
ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3640 CENTRAL AVE, INDIANAPOLIS, IN 46205-3569
(317) 920-7888
Mailing address
5144 INDIANOLA AVE, INDIANAPOLIS, IN 46205-1229
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004768A
IN
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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