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General NPI Number Information
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NPI Number | 1790474047
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Entity Type | Individual
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Provider Name | VICTORIA KATE JOHNSTON OTD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2023
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 2333 ASHLEY RIVER RD
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City | CHARLESTON
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State | SC
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Zip | 29414-4755
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Country | US
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Telephone | 843-258-5538
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Fax |
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Provider Business Mailing Address
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Address Line | 997 JOHNNIE DODDS BLVD APT 217
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-6114
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Country | US
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Telephone | 843-384-0793
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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 | 6348
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License Number State | SC
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