Individual
MS. CONSTANCE P. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6134 WAYNE AVE, APT. 2, PHILADELPHIA, PA 19144-6110
(267) 625-4391
Mailing address
6134 WAYNE AVENUE, APT. 2, PHILADELPHIA, PA 19144
(267) 625-4391
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC001183L
PA
Other
Enumeration date
07/27/2010
Last updated
03/08/2011
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