Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT-2575 | OH |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT-2575 | OH |
NPI | 1255796488 |
---|---|
Provider Name | Ann Johnson |
First Address | Sylvania, OH 43560-2110 |
Second Address | Sylvania, OH 43560-2110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2015 |
Last Update Date | 14/12/2015 |