Individual
MISS JENNIFER JUDITH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
51 WINSHIP ST, BATH, ME 04530-2843
(207) 443-9772
Mailing address
15 PINEWOODS RD, LISBON, ME 04250-6249
(207) 408-6916
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA2184
ME
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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