Individual
EMILY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1218 N DIVISION AVE, SUITE 102, SANDPOINT, ID 83864-5054
(208) 304-0652
Mailing address
1218 N DIVISION AVE, SUITE 102, SANDPOINT, ID 83864-5054
(208) 304-0652
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-956
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT956
STATE OF IDAHO OCCUPATIONAL THERAPY LICENSE
ID
Enumeration date
02/19/2010
Last updated
02/19/2010
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