Individual
KELLI ALMARIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 WEST 75TH STREET, SHAWNEE MISSION, KS 66204
(913) 362-1669
Mailing address
3710 NW LAKE DR, LEES SUMMIT, MO 64064-3020
(816) 478-3368
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
001791
MO
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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