Provider Demographics
NPI:1346588761
Name:JOHNSTON, CHRISTIN NOEL (MOT,OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:NOEL
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MOT,OTR/L
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:NOEL
Other - Last Name:HOLLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT,OTR/L
Mailing Address - Street 1:61 TULIP LN
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1135
Mailing Address - Country:US
Mailing Address - Phone:732-895-3942
Mailing Address - Fax:
Practice Address - Street 1:61 TULIP LN
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1135
Practice Address - Country:US
Practice Address - Phone:732-895-3942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5601225XP0200X
NJ46TR00748600225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5601OtherSTATE LICENSE