Individual
AMANDA RHAE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 685-6264
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008680
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639111057
—
MI
Enumeration date
04/02/2018
Last updated
04/06/2026
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