Provider Demographics
NPI:1649599846
Name:JOHNSON, AIMEE DANIELLE (PT, OT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:DANIELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PT, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 ANNAPOLIS RD
Mailing Address - Street 2:SUITE A3 & A4
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2060
Mailing Address - Country:US
Mailing Address - Phone:301-918-9099
Mailing Address - Fax:301-918-9559
Practice Address - Street 1:9500 ANNAPOLIS RD
Practice Address - Street 2:SUITE A3 & A4
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2060
Practice Address - Country:US
Practice Address - Phone:301-918-9099
Practice Address - Fax:301-918-9559
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06915225X00000X
MD24984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist