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Individual

KIONA LAKAYLA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
2030 EVERGREEN AVE, MODESTO, CA 95350-3785
(209) 577-1055
Mailing address
7174 MILL ARBOR, LITHONIA, GA 30058-8612
(404) 707-0246

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6158
CA

Other

Enumeration date
02/09/2023
Last updated
02/09/2023
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