Provider Demographics
NPI:1497474027
Name:JOHNSTON, NEESHA ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:
First Name:NEESHA
Middle Name:ELIZABETH
Last Name:JOHNSTON
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 1:6336 INVERNESS WAY
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2053
Mailing Address - Country:US
Mailing Address - Phone:513-499-0912
Mailing Address - Fax:
Practice Address - Street 1:7047 HAMILTON MASON RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1424
Practice Address - Country:US
Practice Address - Phone:352-693-6319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT012181225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist