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General NPI Number Information
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NPI Number | 1871492256
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Entity Type | Individual
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Provider Name | CHARLENE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 411 WESTERN ROW RD
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City | MASON
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State | OH
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Zip | 45040
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Country | US
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Telephone | 513-398-1486
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Fax |
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Provider Business Mailing Address
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Address Line | 783 CLOVERVIEW AVE
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City | CINCINNATI
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State | OH
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Zip | 45231-6016
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Country | US
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Telephone | 513-264-1644
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 005640
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License Number State | OH
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