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Individual

DANYELLE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LOTR, MOT

Contact information

Practice address
938 MARTEAU ROAD, BROUSSARD, LA 70518
(337) 459-6591
Mailing address
938 MARTEAU ROAD, BROUSSARD, LA 70518

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
306839
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
02/08/2021
Last updated
02/08/2021
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