Individual
MRS. LISA ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1615 SUNSET AVE, WAUKEGAN, IL 60087-3810
(847) 244-6700
Mailing address
38098 N HOLDRIDGE AVE, BEACH PARK, IL 60087-5416
(630) 890-6025
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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