Provider Demographics
NPI:1003265513
Name:JOHNSTONE, NATALIE (OT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:JOHNSTONE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:VENABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1990 VAUGHN RD NW
Mailing Address - Street 2:SUITE 330
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7098
Mailing Address - Country:US
Mailing Address - Phone:770-917-1395
Mailing Address - Fax:
Practice Address - Street 1:100 LONDON MOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 400
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6668
Practice Address - Country:US
Practice Address - Phone:606-330-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY162046225X00000X
VA0119006453225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist