| NPI | 1821493925 |
|---|---|
| Former Name | KEYSA LYNNE JOHANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: TX 113372) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2014-10-31 |