Individual
KATELYN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4016 RAINTREE RD STE 100A, CHESAPEAKE, VA 23321-3700
(757) 488-2864
Mailing address
4016 RAINTREE RD STE 100A, CHESAPEAKE, VA 23321-3700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007826
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119007826
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
02/13/2019
Last updated
02/13/2019
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