Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 3865 | AZ |
N | 225X00000X | Occupational Therapist | OT 006597 | OH |
N | 2251E1200X | Ergonomics | OT 006597 | OH |
N | 225XE1200X | Ergonomics | OT 006597 | OH |
N | 2251H1300X | Human Factors | OT 006597 | OH |
N | 225XH1300X | Human Factors | OT 006597 | OH |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 3865 | AZ |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT 006597 | OH |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 3865 | AZ |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT 006597 | OH |
NPI | 1124199898 |
---|---|
Provider Name | Melissa J Johnson |
First Address | Gilbert, AZ 85233-2767 |
Second Address | Gilbert, AZ 85234-2726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 10/07/2007 |