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General NPI Number Information
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NPI Number | 1245969849
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Entity Type | Individual
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Provider Name | MEREDITH JOAN JOHNSON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 18 N FORT THOMAS AVE STE 302
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City | FORT THOMAS
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State | KY
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Zip | 41075-1595
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Country | US
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Telephone | 859-441-0139
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Fax |
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Provider Business Mailing Address
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Address Line | 14013 BRIDLEGATE DR
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City | UNION
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State | KY
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Zip | 41091-7563
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Country | US
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Telephone | 859-815-9196
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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 | 363868
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License Number State | KY
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