| NPI | 1578052171 |
|---|---|
| Former Name | MARY ANNE E JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007430) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY TP2018037) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2019-03-06 |