Johanna Marie Judd, MS, OTR/L, CLT
Occupational Therapist in Jacksonville Beach, FL. Individual provider (NPI-1).
NPI number1477964732
StatusActive
Last updated in NPPESSep 3, 2019
Details
- NPI
- 1477964732
- Entity type
- Individual (NPI-1)
- Name
- Miss Johanna Marie Judd
- Credential
- MS, OTR/L, CLT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 8, 2014
- Last updated
- Sep 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | OT16369 | FL | Yes |
| 225X00000X | Occupational Therapist | – | – |
Practice location
340 16th Ave N Ste BJacksonville Beach, FL 32250-4819
Phone 440-413-6379
Mailing address
120 N Churchill DrSt Augustine, FL 32086-4171
Phone 440-413-6379
Other practice locations
1212 13th St N
Jacksonville Beach, FL 32250-3682
Jacksonville Beach, FL 32250-3682
Phone 727-741-3405
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