Individual
MELINDA LEA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
303 N. HURSTBOURNE PARKWAY, SUITE 200, LOUISVILLE, KY 40222
(502) 412-5847
Mailing address
120 FAIRFIELD AVE, BELLEVUE, OH 44811-1008
(419) 217-3687
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.04724
OH
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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