Individual
NICOLE E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1650 45TH AVE, STE 2D, MUNSTER, IN 46321-3962
(219) 836-4921
(219) 836-4923
Mailing address
PO BOX 1381, CROWN POINT, IN 46308-1381
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.010995
IL
225X00000X
Occupational Therapist
Primary
31005874A
IN
Other
Enumeration date
05/13/2015
Last updated
09/30/2019
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