Healthcare Provider Details

I. General information

NPI: 1851229405
Provider Name (Legal Business Name): SANDRA JOYCE JOHANNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 RHODES AVE
NORTH SMITHFIELD RI
02896-6987
US

IV. Provider business mailing address

8 BARBETTE DR
LINCOLN RI
02865-5136
US

V. Phone/Fax

Practice location:
  • Phone: 401-767-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA189
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: