Provider Demographics
NPI:1619598554
Name:JOHNSTON, KATHRYN (COTA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 MOJAVE TRL
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4658
Mailing Address - Country:US
Mailing Address - Phone:832-385-5739
Mailing Address - Fax:
Practice Address - Street 1:104 E HERITAGE DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3854
Practice Address - Country:US
Practice Address - Phone:281-993-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant