Individual
TIFFANY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8000 EVERGREEN RIDGE DR, CINCINNATI, OH 45215-5750
(513) 948-2308
Mailing address
8000 EVERGREEN RIDGE DR, CINCINNATI, OH 45215-5750
(513) 948-2308
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
04713
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04713
OHIO OCCUPATIONAL THERAPY LICENSE
OH
Enumeration date
08/17/2014
Last updated
08/17/2014
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