Individual
SARA REBECCA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA-L
Contact information
Practice address
2521 E 15TH ST, CASPER, WY 82609-4126
(307) 237-7444
Mailing address
4690 TRAILS END, BAR NUNN, WY 82601-9424
(307) 251-4073
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
653
WY
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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