Individual
DYETTA D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
83 SAINT JOHNS ST, EMPORIA, VA 23847-6043
(757) 561-8395
Mailing address
83 SAINT JOHNS ST, EMPORIA, VA 23847-6043
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10840
NC
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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