Individual
TIFFANY NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2911 LONGVIEW DR STE B, JONESBORO, AR 72401-5902
(870) 336-0238
(870) 336-0239
Mailing address
610 N MISSOURI ST STE 1, WEST MEMPHIS, AR 72301-3148
(870) 400-0179
(870) 400-0479
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1430
AR
Other
Enumeration date
01/28/2019
Last updated
02/29/2024
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