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General NPI Number Information
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NPI Number | 1386999423
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Entity Type | Individual
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Provider Name | KARI LYNN JOHNSON OTR
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Gender | Female
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Dates
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Enumeration Date | 07/15/2012
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Last Update Date | 07/15/2012
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Provider Practice Location Address
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Address Line | 2901 INDIANA BLVD APT. 409
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City | DALLAS
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State | TX
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Zip | 75226-1520
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Country | US
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Telephone | 651-208-2155
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 S CAMEO WAY
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1224
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Country | US
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Telephone | 651-208-2155
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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 | 11305
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License Number State | TX
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