Individual
SOPHIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
204 E JACOB ST, LOUISVILLE, KY 40203-2342
(502) 822-3975
Mailing address
4338 CHARLOTTE ANN DR, LOUISVILLE, KY 40216-3402
(502) 389-9594
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
165362
KY
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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