Individual
MISS JOHANNA MARIE JUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L, CLT
Contact information
Practice address
340 16TH AVE N STE B, JACKSONVILLE BEACH, FL 32250-4819
(440) 413-6379
Mailing address
120 N CHURCHILL DR, ST AUGUSTINE, FL 32086-4171
(440) 413-6379
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT16369
FL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
05/08/2014
Last updated
09/03/2019
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