Individual
KELSEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
9109 LIBERTY RD, RANDALLSTOWN, MD 21133-3521
(410) 655-7373
Mailing address
287 WHITAKER RD, PASADENA, MD 21122-1148
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02840
MD
Other
Enumeration date
10/11/2020
Last updated
10/11/2020
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