Individual
PAULA DUDYCHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
2448 S 102ND ST, MILWAUKEE, WI 53227-2466
(414) 329-2500
Mailing address
3095 85TH ST, FREDERIC, WI 54837-4914
(715) 327-5667
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1024-27
WI
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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