Individual
ELAYNA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 MRVL SCTCH CHRCH, PATTERSONVILLE, NY 12137
(518) 779-4608
Mailing address
401 MRVL SCTCH CHRCH, PATTERSONVILLE, NY 12137
(518) 779-4608
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119008269
VA
225X00000X
Occupational Therapist
Primary
023740
NY
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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