Provider Demographics
NPI:1720722325
Name:JOHNSON, MORGAN PAIGE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:PAIGE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6352 TOLLESON RD
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:TN
Mailing Address - Zip Code:37010-5070
Mailing Address - Country:US
Mailing Address - Phone:615-946-8851
Mailing Address - Fax:
Practice Address - Street 1:215 DUNBAR CAVE RD STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8850
Practice Address - Country:US
Practice Address - Phone:800-920-0834
Practice Address - Fax:931-233-9970
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3550224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant