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General NPI Number Information
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NPI Number | 1700096856
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Entity Type | Individual
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Provider Name | MS. LAURA BETH JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3 BURLINGTON WOODS STE 304
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City | BURLINGTON
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State | MA
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Zip | 01803-4514
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Country | US
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Telephone | 888-782-3360
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Fax |
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Provider Business Mailing Address
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Address Line | 20 WASHINGTON ST APT 3
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City | METHUEN
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State | MA
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Zip | 01844-6923
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Country | US
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Telephone | 978-258-3878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 9164
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License Number State | MA
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