Individual
AMANDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
800 S HAM LN, LODI, CA 95242-3543
(209) 368-7141
Mailing address
3440 NORTHSTAR DR, STOCKTON, CA 95209-5103
(209) 479-8864
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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