Healthcare Provider Details

I. General information

NPI: 1992668156
Provider Name (Legal Business Name): JANET JOHNSON HUSBANDS OTR/L, MED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 W BROADWAY AVE
MINNEAPOLIS MN
55411-2533
US

IV. Provider business mailing address

1796 MARYLAND AVE N
GOLDEN VALLEY MN
55427-4162
US

V. Phone/Fax

Practice location:
  • Phone: 612-668-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number101983
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: