Individual
MRS. SHANNON L. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 520-0715
(763) 520-0355
Mailing address
1177 ROSE LN, NEW BRIGHTON, MN 55112-6443
(206) 579-6263
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00004279
WA
Other
Enumeration date
04/04/2007
Last updated
02/27/2009
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