Individual
MRS. STEPHANIE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
350 S RIDGEWOOD AVE, ORMOND BEACH, FL 32174-7028
(386) 677-4545
Mailing address
350 S RIDGEWOOD AVE, ORMOND BEACH, FL 32174-7028
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 10984
FL
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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