Healthcare Provider Details

I. General information

NPI: 1396697488
Provider Name (Legal Business Name): JOHNSTON OCCUPATIONAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 BEAUMONT BEACH RD
DOVER AR
72837-8639
US

IV. Provider business mailing address

671 BEAUMONT BEACH RD
DOVER AR
72837-8639
US

V. Phone/Fax

Practice location:
  • Phone: 479-858-2943
  • Fax:
Mailing address:
  • Phone: 479-858-2943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE JOHNSTON
Title or Position: MANAGING MEMBER
Credential: COTA/L
Phone: 479-858-2943