Individual
JADA NICOLE LESLIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1607 E DIXON BLVD, SHELBY, NC 28152-6976
(704) 473-1675
Mailing address
3052 WINESAP DR, DALLAS, NC 28034-9634
(704) 476-9925
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13273
NC
Other
Enumeration date
06/22/2020
Last updated
03/14/2024
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