Individual
TONDRA LYNETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2848 FAWNWOOD CIR, VALDOSTA, GA 31602-4105
(229) 305-7978
Mailing address
2848 FAWNWOOD CIR, VALDOSTA, GA 31602-4105
(229) 305-7978
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002685
GA
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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