Dolores Ann Johansen, COTA

Individual provider Active NPI Occupational Therapy Assistant · Carson City, MI

NPI 1962068452 · NPPES record last updated May 10, 2019

Key facts

NPI
1962068452
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
620 N 2ND St
Carson City, MI 48811-9790
Phone
(989) 584-6100
NPI assigned
May 10, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X MI Yes
Occupational Therapy Assistant 224Z00000X

Addresses

Primary practice location

620 N 2ND St
Carson City, MI 48811-9790

Mailing address

620 N 2ND St
Carson City, MI 48811-9790

Other providers in Carson City, MI

All providers in Carson City, MI · Occupational Therapy Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.