Individual
MISS LISA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9555 RIBAUT ROAD, BEAUFORT MEMORIAL HOSPITAL, BEAUFORT, SC 29902
(843) 522-5900
Mailing address
2200 PRESERVE AVE W APT 2238, PORT ROYAL, SC 29935-2527
(843) 450-6480
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4024
SC
225XP0200X
Pediatric Occupational Therapist
4024
SC
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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