| NPI | 1174795967 |
|---|---|
| Former Name | STEPHANIE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DE U1-0001870) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC010673) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2018-07-13 |