Provider Demographics
NPI:1487014601
Name:JOHNSON, SARAH HAMPTON (OT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:HAMPTON
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 1:130 OAKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-8592
Mailing Address - Country:US
Mailing Address - Phone:228-348-0694
Mailing Address - Fax:866-404-9501
Practice Address - Street 1:7521 OLD CANTON RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-8669
Practice Address - Country:US
Practice Address - Phone:601-856-8041
Practice Address - Fax:866-404-9501
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT1810225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist