Individual
MELISSA JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1215 TRINITY PL, MISHAWAKA, IN 46545-5000
(574) 208-6844
Mailing address
21999 KERN RD, SOUTH BEND, IN 46614-9295
(574) 292-0927
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002514A
IN
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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