Individual
MS. KATIE LOUISE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
311 S CAMPBELL ST, BURGAW, NC 28425-5011
(910) 259-6007
(910) 259-6111
Mailing address
311 S CAMPBELL ST, BURGAW, NC 28425-5011
(910) 259-6007
(910) 259-6111
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10539
NC
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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