Individual
CHARLENE YVETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
743 HILL AVE, APT#1, SHELBY, MT 59474-2717
(949) 292-2176
Mailing address
743 HILL AVE, APT#1, SHELBY, MT 59474-2717
(949) 292-2176
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA3306
CA
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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