Individual
MISS TAMEKA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
443 LAUREL OAK RD, VOORHEES, NJ 08043-4419
(856) 309-8508
(856) 309-8556
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
46TR00589200
NJ
225XP0200X
Pediatric Occupational Therapist
OC011107
PA
225XP0200X
Pediatric Occupational Therapist
U1-0001188
DE
Other
Enumeration date
05/21/2012
Last updated
06/05/2013
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