Individual
REBECCA SIMMONS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3400 ANDERSON RD STE C, GREENVILLE, SC 29611-7651
(864) 295-9890
Mailing address
103 ONTARIO CT, SIMPSONVILLE, SC 29681-1978
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2742
SC
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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