Individual
ELIZABETH MARY BEAL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
484 JIM GRANT RD, LEBANON, ME 04027-4340
(207) 710-7223
Mailing address
484 JIM GRANT RD, LEBANON, ME 04027-4340
(207) 710-7223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1964
NH
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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