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NPI Code Detail

MEDICARE: MAUREEN ANN JOHNSON OT

MEDICARE: MAUREEN ANN JOHNSON OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist495AK
2225X00000XOccupational Therapist495AK

General Provider Information

NPI Number : 1649577818
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN ANN JOHNSON OT
Provider Business Mailing Address
First Line : PO BOX 242761
Second Line :
City : ANCHORAGE
State : AK
Zip : 99524-2761
Country : US
Telephone Number : 907-223-2567
Fax Number :
Provider Business Practice Location Address
First Line : 124 E 23RD AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2010
Country : US
Telephone Number : 907-223-2567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 02/20/2012

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