Healthcare Provider Details

I. General information

NPI: 1528317476
Provider Name (Legal Business Name): MARGARET JEANNE JOHNSON MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 COLFAX STREET
SCHUYLER NE
68661
US

IV. Provider business mailing address

710 S 201ST AVE
ELKHORN NE
68022-1870
US

V. Phone/Fax

Practice location:
  • Phone: 402-352-3977
  • Fax:
Mailing address:
  • Phone: 402-210-8835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number901031
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: