Provider Demographics
NPI:1043561756
Name:JOHNSON, JARCIA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JARCIA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 STRAWBERRY CT
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-3274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 450
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4216
Practice Address - Country:US
Practice Address - Phone:301-881-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07005225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist