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Individual

NICOLE LEIGH JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
5000 NANNIE HELEN BURROUGHS AVE NE, WASHINGTON, DC 20019-5506
(908) 392-4076
Mailing address
2721 S ADAMS ST, APT. 206, ARLINGTON, VA 22206-2878
(908) 392-4076

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119005295
VA
225X00000X
Occupational Therapist
Primary
OT010000656
DC

Other

Enumeration date
05/03/2011
Last updated
05/03/2011
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