Basic Information
| Provider Information | |||||||||
| NPI: | 1235567207 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | ADRIENNE | ||||||||
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| Credential: | MPS, ATR-BC, LCPAT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 RITTENHOUSE ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200111446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2403053434 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 1ST ST NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200023361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024424800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2013 | ||||||||
| LastUpdateDate: | 10/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 221700000X | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Art Therapist |
No ID Information.