Individual
MICHELENA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2523 CRESTLINE PL, LAWRENCE, KS 66047-2867
(620) 688-0737
Mailing address
2523 CRESTLINE PL, LAWRENCE, KS 66047-2867
(620) 688-0737
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01552
KS
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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