NPI 1336549013

Jennifer Johnson, COTA

Practitioner Physical Disabilities Residential Treatment Facility Bryan, OH

Practice location

Address: 1104 Wesley Ave, Bryan, OH 43506-2579
Phone: (419) 636-5071
Mailing address: 413 E Washington St, Montpelier, OH 43543-1575

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence OTA-05816 (OH)

Other Residential Treatment Facility, Physical Disabilities providers in Ohio →

Registry record

NPI: 1336549013
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Aug 2014
Record last updated: 29 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.