Individual
KIMBERLY M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7080 N 19TH AVE, PHOENIX, AZ 85021-8585
(602) 601-2401
Mailing address
1555 S GILBERT RD STE 109, MESA, AZ 85204-6000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7020
AZ
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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