Individual
DOLORES ANN JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
620 N 2ND ST, CARSON CITY, MI 48811-9790
(989) 584-6100
Mailing address
620 N 2ND ST, CARSON CITY, MI 48811-9790
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
MI
224Z00000X
Occupational Therapy Assistant
—
—
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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