Individual
STEPHANIE AULL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4611 HARD SCRABBLE RD STE 312, COLUMBIA, SC 29229-8584
(479) 200-5283
(803) 339-4037
Mailing address
2704 COUNTS RD, PROSPERITY, SC 29127-7300
(479) 200-5283
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3785
SC
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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