Provider Demographics
NPI:1679772826
Name:JOHNSON, KAREN T (OT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:T
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ERWIN RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4504
Mailing Address - Country:US
Mailing Address - Phone:919-668-3988
Mailing Address - Fax:919-681-5555
Practice Address - Street 1:3000 ERWIN ROAD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4934
Practice Address - Country:US
Practice Address - Phone:919-668-3988
Practice Address - Fax:919-681-5555
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10590225X00000X
NC5544224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant