Most Relevant Information
Provider Data
| NPI Number: | 1003525817 |
| Provider Name: | JESSICA WHITEHERSE JOHNSON COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | OTA0000002329 |
Most Important Dates
| Enumeration Date: | 11/21/2022 |
| Last Updated: | 11/21/2022 |
Provider Practice Location
310 CORPORATE DR SUIT 101
KNOXVILLE
TN
379233792
Practice Location Phone/Fax
| Phone: | 8657690801 |
| Fax: |
Provider Mailing Location
432 GAUT RD
DANDRIDGE
TN
377253202
Provider Mailing Phone/Fax
| Phone: | 3862533751 |
| Fax: |