MISS Thera Elesisus Johnson, CTRS

NPI #1972906055 in Miami Gardens, Florida

Provider Information

NPI Number: 1972906055
Entity Type: Individual
Name: MISS Thera Elesisus Johnson, CTRS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Recreation Therapist
Credential: CTRS
Enumeration Date: Oct 2, 2014
Last Updated: Oct 2, 2014

Practice Location

Address: 2031 NW 184TH ST
City: Miami Gardens
State: Florida
ZIP Code: 33056-2753
Phone: (305) 502-8923

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Recreation Therapist	225800000X	Primary

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