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General NPI Number Information
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NPI Number | 1972305357
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Entity Type | Individual
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Provider Name | QUINNE JOHNSON OTR/L, OTD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1585 3RD ST
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City | FORT JOHNSON
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State | LA
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Zip | 71459-5102
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Country | US
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Telephone | 337-531-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 2104 JEAN ST
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City | LEESVILLE
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State | LA
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Zip | 71446-4573
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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 | 107578
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License Number State | MN
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