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General NPI Number Information
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NPI Number | 1073843488
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Entity Type | Individual
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Provider Name | JENNIFER E JOHNSON MS, OTR
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Gender | Female
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 1907 W SYCAMORE ST
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City | KOKOMO
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State | IN
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Zip | 46901-5148
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Country | US
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Telephone | 765-456-5442
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Fax |
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Provider Business Mailing Address
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Address Line | 9667 AMBER GLOW CT
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City | FISHERS
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State | IN
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Zip | 46037-9444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31001255A
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License Number State | IN
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