Individual
MISS JEANANNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
140 7TH AVE, NEW YORK, NY 10011-1843
(917) 922-2199
Mailing address
140 7TH AVE APT 6J, NEW YORK, NY 10011-1838
(917) 922-2199
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010858-01
NY
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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