Individual
VICTORIA C JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47 WYNNFIELD DR, PALM COAST, FL 32164-4208
(386) 237-4475
Mailing address
47 WYNNFIELD DR, PALM COAST, FL 32164-4208
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11970
FL
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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